Results of portal vein and hepatic artery resection for surgical treatment of Klatskin tumor

Abstract

Background: Portal vein invasion is most often cause of portal vein resection and reconstruction combine with hepatectomy for surgical treatment of Klatskin tumor at nowadays. The reported rate of morbidity and mortality still high (more then 10%). 5-year survival is possible. Special complexity is represented by cases with a tumor invasion of a portal vein and a hepatic artery. Results of combine resection portal vein and hepatic artery still controversial. Methods: The aim of this study to observe results of surgical treatment of Klatskin tumor with portal vein and hepatic artery invasion. Between 2002 and 2016 major and extended resections of the liver to 183 patients with Klatskin tumor was made. Results: 183 patients underwent resection for pCCA. Median age was 61,2 ±/12 years. More than in 45 % of cases there was a necessity of a separate drainage of three sections of a liver. A liver resection carried out at level of bilirubin of a blood not above 60 mcmol/l. From 183 patients in 96 cases have executed a resection of a portal vein with the subsequent reconstruction. At 13 patients it is made hepatoduodenoligamentectomy with resection and reconstruction of portal vein and hepatic artery. The postoperative mortality has made 9,3 %, 5-year survival rate – 18,8 %. Conclusion: Aggressive surgical treatment for cholangiocarcinoma the confluence of bile duct with portal vein resection can be performed safely with acceptable mortality and long-term survival rate.