title: Study of the intrahepatic surgical margin of hilar bile duct carcinoma.
abstract: OBJECTIVE
  The diagnosis and treatment for hilar bile duct carcinoma has greatly improved. Frozen section is one of the modalities used to determine the intrahepatic surgical margin and the surgical approach for tumor resection. But we are sometimes faced with the case where we are perplexed whether to carry out additional surgical resection or not according to the result of frozen section, due to its inaccuracy. We studied herein the relation between the prognosis and the intrahepatic surgical margin according to the result of frozen section.
  
  
  METHODS
  We reviewed 23 cases of hilar bile duct carcinoma whose intrahepatic surgical margin was determined by frozen section and studied the cause of death and surgical procedure. Results of the frozen sections were compared with the permanent paraffin sections.
  
  
  RESULTS
  The overall survival rates at 1, 3 and 5 years after operation were 68.1, 41.3, and 33.0%, respectively. The accuracy, sensitivity and specificity of frozen section was 56.5%, 75.0%, and 46.7%, respectively.
  
  
  CONCLUSIONS
  We concluded that by evaluating the diagnosis of frozen section during the surgery it was difficult to determine intrahepatic surgical margin. Aggressive hepatic resection sometimes causes a high risk of hepatic failure in which case the histological diagnosis of the frozen section throughout should not be carried out.
authors.affiliation: Department of Surgery, Kochi Municipal Central Hospital, Kochi, Japan. yas.okazaki@nifty.ne.jp
authors.forename: Yasunaga
authors.initials: Y
authors.lastname: Okazaki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Horimi
authors.forename: Masahito
authors.initials: M
authors.lastname: Kotaka
authors.forename: Sojiro
authors.initials: S
authors.lastname: Morita
authors.forename: Motohiro
authors.initials: M
authors.lastname: Takasaki
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D005260:Female; D005629:Frozen Sections; D006498:Hepatectomy; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity