title: Hilar cholangiocarcinoma in cirrhotic liver: a case-control study.
abstract: BACKGROUND
  Surgical resection is the only hope for patients with cholangiocarcinoma (CC). This study is designed to assess the impact of cirrhosis on the outcome of surgical management for CC.
  
  
  METHODS
  We retrospectively studied all patients who underwent surgical resection for hilar CC. Group I (patients with cirrhotic liver) and Group II (patients with non-cirrhotic liver). Preoperative demographic data, intra-operative data, and postoperative details were collected.
  
  
  RESULTS
  Only 102/243 patients (41.9%) had cirrhotic liver. Caudate lobe resection was more frequently performed in the non-cirrhotic group (P = <0.001). There was no difference between both groups regarding intraoperative blood loss and the need for blood transfusion. The median postoperative stay was higher in the cirrhotic group (P = 0.063). The incidence of early postoperative liver cell failure was significantly higher in the cirrhotic group (P = <0.001). Cirrhosis was associated with significantly lower overall survival (P = <0.001).
  
  
  CONCLUSIONS
  Patients with concomitant liver cirrhosis and hilar CC should not be precluded from surgical resection and should be considered for resection at high volume centers with expertise available to manage liver cirrhosis. The incidence of early postoperative liver cell failure was significantly higher in the cirrhotic group.
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, 35516, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdelwahab
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, 35516, Egypt. Electronic address: elnakeebayman@yahoo.com.
authors.forename: Ayman
authors.initials: A
authors.lastname: El Nakeeb
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, 35516, Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: Salah
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, 35516, Egypt.
authors.forename: Hosam
authors.initials: H
authors.lastname: Hamed
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, 35516, Egypt.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Ali
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, 35516, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Sorogy
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, 35516, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Shehta
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, 35516, Egypt.
authors.forename: Helmy
authors.initials: H
authors.lastname: Ezatt
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, 35516, Egypt.
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Sultan
authors.affiliation: Gastroenterology Surgical Center, Pathology Department, Egypt.
authors.forename: Khaleed
authors.initials: K
authors.lastname: Zalata
mesh_terms: D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D016022:Case-Control Studies; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Cholangiocarcinoma; Cirrhosis; Hepatic resection