Aggressive surgical treatment for hilar cholangiocarcinoma

We reviewed our experience with aggressive surgical management in 144 patients with hilar cholangiocrcinoma. Curative resection was obtained in 69% of 144 resceted patients, and provided a better survival of 40% at 5-year survival rate than 0% of non-curative resection. Forty-one patients underwent portal vein resection and reconstruction, and hepatic artery resection in 8 patients. Survival rate was significantly lower in the patients with combined vascular resection than that in the patients without vascular resection, 57% vs 14% at 5-year survival in curative resection. However, combined vascular resection provided significantly, better survival than nonsurgical intervention. Surgical morbidity rate was 42% and mortality rate was 6.9% in all resected patients. In highly selected patients with hilar cholangiocarcinoma localized at hepatic hilus, a parencliyma-preserving-hepatectomy can be selected., and could bring about a benefical effect in patients with high risk.