title: Trisectionectomy for cholangiocarcinoma: is it worth it?
abstract: Many centers perform aggressive liver resection for patients with cholangiocarcinoma, because improved survival has been reported after resection with negative margins. Patients with extensive tumor burden sometimes require trisectionectomy for clearance of disease with increased risk of liver insufficiency and postoperative complications. A retrospective review was conducted examining records for 62 patients who were taken to the operating room for cholangiocarcinoma from January 1, 2000, to March 31, 2010. Thirty-eight patients underwent surgical resection: 17 patients underwent trisectionectomy and 21 patients underwent liver resections. No statistically significant differences were found between patients who underwent liver resection compared with those who underwent trisectionectomy with regard to demographics or complications. Pathology was rereviewed by a single pathologist, and no statistically significant differences were found between the two groups in any of the recorded pathology results. No significant differences in survival were found between the two groups. The median survival for liver resection patients was 2.9 years and for trisegmentectomy patients was 2.8 years. Complete resection with negative margins remains the current surgical goal in the treatment for cholangiocarcinoma. Performing trisectionectomy in an effort to clear all disease is safe with comparable outcomes to patients needing less extensive liver resections.
authors.affiliation: Department of Surgery, Keck School of Medicine at the University of Southern California, Los Angeles, California, USA.
authors.forename: Lea
authors.initials: L
authors.lastname: Matsuoka
authors.forename: Sophoclis
authors.initials: S
authors.lastname: Alexopoulos
authors.forename: Lydia
authors.initials: L
authors.lastname: Petrovik
authors.forename: Linda
authors.initials: L
authors.lastname: Chan
authors.forename: Yuri
authors.initials: Y
authors.lastname: Genyk
authors.forename: Rick
authors.initials: R
authors.lastname: Selby
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D002140:California / Q000453:epidemiology; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome