KMID : 1143920180220030216
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Annals of Hepato-Biliary-Pancreatic Surgery 2018 Volume.22 No. 3 p.216 ~ p.222
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A retrospective review of correlative radiological assessment and surgical exploration for hilar cholangiocarcinoma
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Chua Darren
Low Albert Koh Yexin Goh Brian Cheow Peng Chung Kam Juinn Har Teo Jin Yao Tan Ek Khoon Chung Alexander Ooi London Lucien Chan Chung Yip Lee Ser Yee
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Abstract
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Backgrounds/Aims: Hilar cholangiocarcinomas (HCCAs) are tumors that involve the biliary confluence; at present, radical surgery offers the only chance of long-term survival, but this can be challenging given the complexity of the hilar anatomy. Blumgart and Jarnagin described a preoperative staging system that incorporates the effect of local tumor extent and its impact on adjacent structures and that has been demonstrated to correlate better with actual surgical resectability. The primary aim of this study is to describe the correlation between preoperative Blumgart-Jarnagin staging and its correlation with surgical resectability.
Methods: Patients who underwent surgical resection for hilar cholangiocarcinoma at Singapore General Hospital between January 1, 2002, and January 1, 2013, were identified from a prospectively maintained institutional database. All patients were staged based on the criteria described by Blumgart and Jarnagin. Correlation with surgical resectability was then determined.
Results: A total of 19 patients were identified. Overall resectability was 57.8% (n=11). Patients with Blumgart-Jarnagin stage T1 had the highest rates of resectability at 80%; patients with stage T2 and T3 disease had resectability rates of 25% and 40% respectively. Median overall survival was 13.6 months.
Conclusions: The Blumgart-Jarnagin staging system is useful for predicting tumor resectability in HCCA.
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KEYWORD
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Klatskin, Blumgart-janargin, Resectability, Hilar cholangiocarcinoma, Pre-operative
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