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dc.contributor.authorJegatheeswaran, S.
dc.contributor.authorStathakis, P.
dc.contributor.authorSpiers, H. V. M.
dc.contributor.authorMohammed, F.
dc.contributor.authorPetras, P.
dc.contributor.authorSatyadas, T.
dc.contributor.authorParker, M. J.
dc.contributor.authorLamarca, A.
dc.contributor.authorJamdar, S.
dc.contributor.authorSheen, A. J.
dc.contributor.authorSiriwardena, A. K.
dc.date.accessioned2022-04-28T13:57:49Z
dc.date.available2022-04-28T13:57:49Z
dc.date.issued2022en
dc.identifier.citationJegatheeswaran S, Stathakis P, Spiers HVM, Mohammed F, Petras P, Satyadas T, et al. Work-Up and Outcome of Hepatic Resection for Peri-Hilar Cholangiocarcinoma (PH-CCA) without Staging Laparoscopy. Cancers. 2022;14(7):12.en
dc.identifier.doi10.3390/cancers14071841en
dc.identifier.urihttp://hdl.handle.net/10541/625187
dc.description.abstractBackground: This study reports the outcome of a work-up programme for resection of peri-hilar cholangiocarcinoma (PH-CCA) without the use of staging laparoscopy. Methods: This is a clinical case cohort series of patients undergoing surgical resection of PH-CCA without the use of staging laparoscopy in the work-up algorithm. During the 13 years from 1 January 2009 to 1 January 2022, 32 patients underwent laparotomy for planned surgical resection of PH-CCA. Data were collected on demographic profile, admission biochemistry, radiology, pre-operative intervention, operation and outcome, together with post-operative complications and disease-free and overall survival. Results: All patients underwent pre-operative contrast-enhanced CT. Twenty-four (75%) underwent pre-operative MR. Twenty-three (72%) underwent pre-operative biliary drainage. Twenty-nine patients (91%) had either type III or IV peri-hilar cholangiocarcinoma. One patient (3%) in this series underwent a non-resectional laparotomy. Twenty-nine (91%) had a final histopathological diagnosis of PH-CCA. One further patient had a final diagnosis of an intraductal papillary neoplasm of the biliary tree (IPNB) with high-grade dysplasia but no invasive cancer. Eleven patients (36%) received chemotherapy after surgery. The median (95% CI) time to recurrence was 14 (7–31) months. The median survival was 25 (18-upper limit not reached) months. Conclusion: This cohort of 32 patients undergoing attempted resection for PH-CCA without the use of staging laparoscopy in the work-up algorithm indicates that with careful attention to patient fitness and cross-sectional and interventional radiologic/endoscopic imaging, a very low non-therapeutic laparotomy rate of 3% can be achieved and sustained.en
dc.language.isoenen
dc.relation.urlhttps://dx.doi.org/10.3390/cancers14071841en
dc.titleWork-Up and Outcome of Hepatic Resection for Peri-Hilar Cholangiocarcinoma (PH-CCA) without Staging Laparoscopyen
dc.typeArticleen
dc.identifier.journalCancersen
dc.description.noteen]


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