• M Esaki, K Shimada, S Nara, Y Kishi, Y Sakamoto, T Kosuge, and T Sano.
• Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital, Tokyo, Japan. mesaki@ncc.go.jp
• Br J Surg. 2013 May 1;100(6):801-7.

BackgroundData on outcomes of left hepatic trisectionectomy (LT) for perihilar cholangiocarcinoma are limited. The aim of this study was to clarify short- and long-term outcomes of LT for perihilar cholangiocarcinoma.MethodsPatients with perihilar cholangiocarcinoma who underwent LT between January 2000 and October 2011 were analysed. Surgical variables, mortality, morbidity (Clavien grade I-V), recurrence sites and survival were compared between subjects who underwent LT, right hemihepatectomy or left hemihepatectomy.ResultsA total 214 patients underwent resection for perihilar cholangiocarcinoma, 25 (11·7 per cent) of whom underwent LT, 88 (41·1 per cent) right hemihepatectomy and 94 (43·9 per cent) left hepatectomy. There were no deaths among those who had LT, but 20 patients developed complications. The incidence of grade IIIa complications was significantly higher among patients who underwent LT than in patients who had right or left hemihepatectomy (P = 0·001 and P < 0·001 respectively). Only one patient developed a grade IIIb or IV complication (liver failure) after LT. The overall 5-year survival rate after LT was 39 per cent and median survival was 45 months. There were no significant differences in survival between patients who underwent LT and those who had a right or left hemihepatectomy.ConclusionLT may provide a good outcome for advanced perihilar cholangiocarcinoma.© 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

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