[Anatomy problems in the radical resection for hilar cholangiocarcinoma].
OBJECTIVE
To analyze the clinical data, surgical strategies and results from the patients with hilar cholangiocarcinoma (HCCA), and to explore the anatomic factors related to the radical resection.


METHODS
The data from 52 patients with HCCA who underwent radical resection between January 1984 to December 2008 were investigated retrospectively, which included clinical diagnosis, Bismuth-Corlette classification, pathologic features, surgical procedures and follow-up results.


RESULTS
According to the Bismuth-Corlette classification, 5, 12, 6, 16 and 13 patients belonged to type I, II, IIIa, IIIb and IV respectively. There were 24 cases underwent combined hepatic lobectomy. The 1-, 3- and 5-year survival rates were 78.8%, 36.4% and 12.1% respectively. Postoperative complications rate was 30.8% with the 3.8% mortality rate. The frequency of surgical complications was significantly higher in patients with higher level of serum total bilirubin (> 340 micromol/L) than that in patients with a relatively lower one (170 micromol/L) before operation (P < 0.05).


CONCLUSIONS
Some anatomical factors should be considered during the radical resection of hilar cholangiocarcinoma, especially evaluation of potential hepatectomy, resection of caudate lobe, hepatic artery resection and/or reconstruction. The prognosis of the patients underwent R(0) radial resection could be significantly improved.
Geng
Xiao-ping
XP
Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230032, China. xp_geng@163.net
Zhu
Hua-gang
HG
Liu
Fu-bao
FB
Hou
Hui
H
Zhang
Zhi-gong
ZG
Zhao
Hong-chuan
HC
Wang
Guo-bin
GB
Zhao
Yi-jun
YJ
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000033:anatomy & histology; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies