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자료유형
학술저널
저자정보
In Woong Han (Dongguk University College of Medicine) Jin-Young Jang (Seoul National University College of Medicine) Mee Joo Kang (Seoul National University College of Medicine) Wooil Kwon (Seoul National University College of Medicine) Jae Woo Park (Seoul National University College of Medicine) Ye Rim Chang (Seoul National University College of Medicine) Sun-Whe Kim (Seoul National University College of Medicine)
저널정보
대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.87 No.2
발행연도
2014.7
수록면
87 - 93 (7page)

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Purpose: Extended liver resection may provide long-term survival in selected patients with Bismuth type IV hilar cholangiocarcinoma (HCCA). The purpose of this study was to identify anatomical factors that predict curative-intended resection.
Methods: Thirty-three of 159 patients with Bismuth type IV HCCA underwent major hepato-biliary resection with curative intent (CIR) between 2000 and 2010. Disease extent and anatomical variations were analyzed as factors enabling CIR.
Results: CIR ratio with hilar trifurcation bile duct variation (13/16) was significantly higher than that with other bile duct variation types (18/25). Hilum to left second bile duct confluence and tumor infiltration over left second bile duct confluence lengths in right-sided CIR were significantly shorter than those lengths in left-sided CIR (10.8 ± 4.9 and 2.7 ± 0.8 mm vs. 16.5 ± 8.4 and 7.0 ± 5.3 mm, respectively). Left-sided CIR patients had a marginally higher proportion of tumors invading ≤5 mm over the right second confluence than that in right-sided CIR patients (13/17 vs. 6/16; P = 0.061). The 3-year survival rate after CIR (28%) was significantly higher than after non-CIR (6.1%).
Conclusion: We recommend the criteria of CIR as bile duct variation type, length of hilum to contralateral second bile duct confluence, and extent of tumor infiltration over the second confluence for Bismuth type IV HCCA.

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