Right-side versus left-side hepatectomy for the treatment of hilar cholangiocarcinoma: A comparative study

Hye Sung Jo, Dong Sik Kim, Young Dong Yu, Woo Hyoung Kang, Kyung Chul Yoon

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Radical resection is the only curative treatment for patients with hilar cholangiocarcinoma. While left-side hepatectomy (LH) may have an oncological disadvantage over right-side hepatectomy (RH) owing to the contiguous anatomical relationship between right hepatic inflow and biliary confluence, a small future liver remnant after RH could cause worse surgical morbidity and mortality. We retrospectively compared surgical morbidity and long-term outcome between RH and LH to determine the optimal surgical strategy for the treatment of hilar cholangiocarcinoma. Methods: This study considered 83 patients who underwent surgical resection for hilar cholangiocarcinoma between 2010 and 2017. Among them, 57 patients undergoing curative-intent surgery including liver resection were enrolled for analysis-33 in the RH group and 27 in the LH group. Prospectively collected clinicopathologic characteristics, perioperative outcomes, and long-term survival were evaluated. Results: Portal vein embolization was more frequently performed in the RH group than in the LH group (18.2% vs. 0%, P = 0.034). The proportion of R0 resection was comparable in both groups (75.8% vs. 75.0%, P = 0.948). The 5-year overall and recurrence-free survival rates did not differ between the groups (37.7% vs. 41.9%, P = 0.500, and 26.3% vs. 33.9%, P = 0.580, respectively). The side of liver resection did not affect long-term survival. In multivariate analysis, transfusion (odds ratio, 3.12 [1.42-6.87], P = 0.005) and post-hepatectomy liver failure (≥ grade B, 4.62 [1.86-11.49], P = 0.001) were independent risk factors for overall survival. Conclusions: We recommend deciding the side of liver resection according to the possibility of achieving radical resection considering the anatomical differences between RH and LH.

Original languageEnglish
Article number3
JournalWorld Journal of Surgical Oncology
Volume18
Issue number1
DOIs
Publication statusPublished - 2020 Jan 4

Keywords

  • Hepatectomy
  • Hilar cholangiocarcinoma
  • Radical resection

ASJC Scopus subject areas

  • Surgery
  • Oncology

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