title: Role of hilar resection in the treatment of hilar cholangiocarcinoma.
abstract: OBJECTIVE
  The aim of this study was to clarify the role of bile duct resection without hepatectomy (hilar resection) in hilar cholangiocarcinoma.
  
  
  METHODS
  We retrospectively compared surgical results for hilar cholangiocarcinoma between 8 patients treated with hilar resection and 21 patients treated with hepatectomy.
  
  
  RESULTS
  All hilar resections were performed for Bismuth type I or II tumors with T2 or less lesions, whereas hepatectomy was done for type III or IV tumors excluding one type II tumor. R0 resection was equally achieved in both groups (62.5% in hilar resection group and 76.2% in hepatectomy group, p=0.469) and overall 5-year survival rates were comparable (21.9% vs. 23.6%, p=0.874). With respect to gross tumor appearance, R0 resection was achieved in all patients with papillary tumor in both groups with the excellent 5-year survivals (100% vs. 100%). In patients with nodular and flat tumors, R0 resection was achieved less frequently in the hilar resection vs. hepatectomy group (50% vs. 77.8%) mainly due to failure to clear the proximal ductal margin, resulting in poorer 5-year survival (0% vs. 18.7%).
  
  
  CONCLUSIONS
  Hilar resection may be indicated for papillary T1 or 2 tumors in Bismuth type I or II cholangiocarcinoma.
authors.affiliation: Department of Surgical Oncology, Miyazaki University School of Medicine, Miyazaki, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Otani
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chijiiwa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kai
authors.forename: Jiro
authors.initials: J
authors.lastname: Ohuchida
authors.forename: Motoaki
authors.initials: M
authors.lastname: Nagano
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kondo
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D018281:Cholangiocarcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome