To review our 34-year experience with 574 consecutive resections for perihilar cholangiocarcinoma and to evaluate the progress made in surgical treatment of this disease.Few studies have reported improved outcomes cholangiocarcinoma; therefore, it is still unclear whether intractable disease has progressed.Between April 1977 December 2010, a total 754 patients were treated, whom (76.1%) underwent resection. The medical records these resected retrospectively reviewed.The incidence major...

Use of synbiotics has been reported to benefit human health, but clinical value in surgical patients remains unclear.To investigate the effect perioperative oral administration upon intestinal barrier function, immune responses, systemic inflammatory microflora, and outcome undergoing high-risk hepatobiliary resection.Patients with biliary cancer involving hepatic hilus (n = 101) were randomized before hepatectomy, into a group receiving postoperative enteral feeding (group A); or another...

Abstract Background Few larger studies have estimated the incidence of incisional hernia (IH) after abdominal surgery. Methods Patients who had surgery between November 2009 and February 2011 were included in study. The rate risk factors for IH monitored at least 180 days. Results A total 4305 consecutive patients registered. Of these, 378 excluded because failure to complete follow-up 3927 analysed. was diagnosed 318 patients. rates 5·2 per cent 12 months 10·3 24 months. In multivariable...

Abstract Background It is difficult to predict hepatic functional reserve accurately before major hepatectomy. The aim of this study was analyse the usefulness future liver remnant plasma clearance rate indocyanine green (ICGK-F, calculated as (ICGK) × proportion remnant) in predicting death after Methods Data on ICGK and ICGK-F were collected prospectively analysed retrospectively for 274 patients who underwent right hepatectomy, trisectionectomy or left biliary cancer between 1991 2008....

To outline our experience with hepatopancreatoduodenectomy (HPD) as a treatment for cholangiocarcinoma and to appraise the clinical significance of this challenging procedure.Cholangiocarcinomas often exhibit an extensive ductal spread invading from hepatic hilus lower bile duct, such tumors can be completely resected only by HPD. Early experiences HPD were associated high mortality morbidity, leading underestimation survival benefit HPD.We retrospectively reviewed medical records 85...

Abstract Objective To review our surgical experience with hilar cholangiocarcinoma in the “new era.” Methods The medical records of 428 patients who underwent treatment between 2001 and 2008 at First Department Surgery, Nagoya University Hospital, were retrospectively reviewed. Results Of patients, 298 (70%) resection (R0, n = 220; R1, 70; R2, 8). Portal vein was performed 111 (37%) hepatic artery 53 (18%) patients. Several different types postoperative complications occurred a total 129...

To analyze lymph node status in resected perihilar cholangiocarcinoma, to clarify which index (ie, location, number, or ratio of involved nodes) is better for staging, and determine the minimum requirements examination.In TNM classification number nodes not considered nodal staging. The requirement histologic examination arbitrary.This study 320 patients with cholangiocarcinoma who underwent resection from January 2000 December 2009 at Nagoya University Hospital. relationship between patient...

<i>Backgrounds:</i> Portal vein embolization (PVE) has been widely applied before extended hepatectomy; however, its clinical utility for patients with biliary cancer not fully addressed. <i>Methods:</i> Between 1991 and 2010, 494 cholangiocarcinoma (n = 353) or gallbladder 141) underwent PVE hepatectomy. was performed by a transhepatic ipsilateral approach using fibrin glue absolute ethanol steel coils. Surgical outcomes of this cohort were retrospectively reviewed....

Bismuth type IV perihilar cholangiocarcinoma has traditionally been categorized as unresectable disease. The aim of this study was to review experience with a resection-based strategy in patients who have cholangiocarcinoma.Medical records consecutive diagnosis between 2006 and 2015 were reviewed retrospectively. Primary outcomes assessed surgical results long-term survival.Of the 332 tumour, 216 (65·1 per cent) underwent resection. Left hepatic trisectionectomy most common procedure (112...

To review our experiences with left-sided hepatectomy for perihilar cholangiocarcinoma, to compare left trisectionectomy, and evaluate the clinical significance of trisectionectomy from viewpoint surgical oncology.Only 4 large case series have been reported on only a few patients diagnosed cholangiocarcinoma. Therefore, oncologic advantage compared cholangiocarcinoma is still unclear.This study involved 201 who underwent (86 trisectionectomies 115 hepatectomies). Surgical outcome survival...

To clarify the value of resection gallbladder cancer involving extrahepatic bile duct.: Several recent studies have proven that jaundice and biliary involvement are independent predictors a poor outcome. Only few authors recommend such advanced disease.One hundred patients with pT3/4, pN0/1, M0 disease were subjects this study. Mortality long-term outcome analyzed using prospectively collected database.The only factor associated mortality in univariate multivariate analyses was...

To review our experiences with surgery for recurrent biliary tract cancer (BTC).Few studies have reported on surgical procedures BTC; therefore, it is unclear whether this has survival benefit.Between 1991 and 2010, 606 patients had recurrences after resection of BTC (gallbladder cancer, n = 135; cholangiocarcinoma, 471); 74 underwent recurrence, whereas the remaining 532 did not. The medical records were retrospectively reviewed.Compared without less advanced their time to recurrence was...

The aim of the study was to evaluate whether carcinoma in situ (CIS) residue at ductal stump affects survival patients undergoing resection for extrahepatic cholangiocarcinoma.Positive margin with CIS has been treated as a tumor-free from prognostic viewpoint because several studies have reported that residual foci do not affect after resection.Patients who underwent cholangiocarcinoma were retrospectively reviewed. surgical status histologically divided into negative (R0), positive (R1cis),...

Abstract Background Right-sided hepatectomy is often selected for perihilar cholangiocarcinoma because the extrahepatic portion of left hepatic duct longer than that right duct. However, length resected in right-sided has not been reported. Methods Patients who underwent were reviewed retrospectively. Trisectionectomies performed according to a previously reported technique anatomical trisectionectomy. Right was standard operative procedures. The measured. Results Thirty-three patients...

To evaluate the optimal duration of antimicrobial prophylaxis in patients undergoing "complicated"' major hepatectomy with extrahepatic bile duct resection.To date, 4 randomized controlled trials (RCTs) have assessed after hepatectomy. However, all these previous studies involved only "simple" without resection.Patients suspected hilar obstruction scheduled to undergo complicated biliary drainage were 2-day (antibiotic treatment on days 1 and 2) or 4-day (on 4) groups. Antibiotics selected...