Téma: Overview works

Possibilities of surgical therapy of cholangiocellular carcinoma

Ľudovít Laca, Mazyar Fani, Ján Janík, Igor Šinák, Blažej Palkóci, Jozef Urdzik, Rudolf Hyrdel, Hubert Poláček, Kamil Zeleňák, Juraj Miklušica, Marek Adámik, Michal Hošala

Currently a different view has been taken to radical therapy of malignant tumors of the bile ducts. It is the result of development of medical techniques one side and on the other side the improvement of preoperative preparation and postoperative care of patients after large combined resection procedures. In the period from December 2003 to December 2008 at the Clinic of Transplant and Vascular Surgery JLF UK in Martin 89 patients with primary cholangiocellular carcinoma (CCC) of the bile duct were operated. Intrahepatal CCC developed in 12 patients (13 %), perihilar type – Klatskin´s tumor in 39 patients (44 %), cholecyst carcinomas in 17 patients (19 %) and distal choledochus carcinomas in 21 patients (24 %). Radical resection of liver and bile ducts and proximal pancreatoduodenectomy (PDE) were performed in 58 pts (65 %). One-year and three-year surviving after radical surgical procedures was 65 % and 51 % respectively. R-B resections had surviving of 68 %. As far as the location is concerned the best surviving was reported in intrahepatal cholangiocarcinomas and the worst in gall bladder carcinomas. Postoperative complications occurred in 16 pts (18 %). They were abscesses, dehiscences of biliodigestive anastomosis, postoperative dysfunction of liver, biliar fistule and gastrointestinal tract bleeding. Mortality up to 30 days after surgical procedure was zero. On basis of our results the method of choice of therapy of cholangiocarcinomas of bile ducts is radical resection of tumor with histological negative resection borders (R-B) which have markedly higher surviving rate than palliative bypass or drainage procedures.

Ročník 2009  Témy časopisu Gastroenterology for practice 1 / 2009

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