Resection of the portal vein in the treatment of perihilar cholangiocarcinoma

Abstract

Background. Perichilar cholangiocarcinoma is a rare type of malignant neoplasm, and its incidence is 3–7 cases per 100,000 population. Surgery is the only radical method of treatment allowing to improve long-term survival results. The cases with tumor invasion of the portal vein are of particular complexity. The purpose of this research was to study the results of surgical treatment of patients with perihilar cholangiocarcinoma with invasion of the portal vein. Materials and methods. From 2003 to 2017, in the department of transplantation and surgery of the liver, extensive and advanced liver resections were preformed in 153 patients with perihilar cholangiocarcinoma. Results. To establish the nature of the lesion of the biliary tree, Bismuth-Corlette anatomical classification of the perihilar cholangiocarcinoma was used. Out of 153 patients, in 66 (43 %) cases, a portal vein resection was performed with subsequent reconstruction. One-, three- and five-year survival rate in the group of patients with portal vein resection was 81.8, 40.9 and 31.8 %, respectively. Conclusions. Aggressive surgical treatment of perihilar cholangiocarcinoma provides maximum radicality, allows to increase resectability in case of tumor invasion of the portal vein with acceptable mortality and long-term survival.