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J Hepatobiliary Pancreat Sci · Jul 2016
Comparative StudyConcomitant hepatic artery resection for advanced perihilar cholangiocarcinoma: a case-control study with propensity score matching.
- Takehiro Noji, Takahiro Tsuchikawa, Keisuke Okamura, Kimitaka Tanaka, Yoshitsugu Nakanishi, Toshimichi Asano, Toru Nakamura, Toshiaki Shichinohe, and Satoshi Hirano.
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
- J Hepatobiliary Pancreat Sci. 2016 Jul 1; 23 (7): 442-8.
BackgroundWhether concomitant hepatic artery resection (HAR) improves the prognosis for advanced perihilar cholangiocarcinoma remains controversial. The aim of the present study was to compare short- and long-term surgical results of HAR versus standard resection (SR) for perihilar cholangiocarcinoma using propensity score matching.MethodsAmong 209 patients with perihilar cholangiocarcinoma patients who underwent resection in our department, 28 patients underwent HAR, and the remaining 181 patients underwent SR. To adjust for differences in clinicopathological factors, including difficulty in surgery, between groups, propensity score matching was used at a 1:1 ratio, resulting in a comparison of 24 patients per group. The study protocols were approved by our institutional review board (015-0365), enrolled in UMIN-CTR (No: UMIN000019927), and conducted according to the Declaration of Helsinki.ResultsNo significant differences were seen in overall incidence of postoperative complications (Clavien-Dindo classification ≥IIIa: 37.5% in SR group vs. 62.5% in HAR group; P = 0.080), except for postoperative liver abscess formation (P = 0.020). Five-year overall survival rates were 30.3% and 20.4%, respectively. No significant difference in overall survival rate was apparent between the SR and HAR groups (P = 0.150).ConclusionDespite being a demanding procedure, concomitant HAR appears feasible for selected patients with perihilar cholangiocarcinoma.© 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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