Case Report - Sciedu Press

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Nov 23, 2011 - Hilar cholangiocarcinoma (HCCA) is a challenging problem for surgeons because surgery is the only effective therapy for these patients. In this ...
www.sciedu.ca/jst                                                                                                                                Journal of Solid Tumors, 2011, Vol. 1, No.3 

-Original Clinical Research-

Hilar cholangiocarcinoma fifteen-year experience with 243 patients at a single Egyptian center Mohamed Abdel Wahab1, Omar Fathy1,Ahmad Mohamed Sultan1,Tarek Salah1,Mohamed Elshoubary2, Ahmed Yossef Abo Elyazid2, Nabieh Anwar1, Ahmad Sultan1 Gastroenterology Center1, Health and Community Medicine2,Mansoura University, Gehan st, Mansoura, Dakahlia 35516,Egypt.

Corresponding author: Mohamed Abdel Wahab, Gastroenterology Center, Gehan st, Mansoura, Dakahlia 35516, Egypt. Email: [email protected],Tel : +2 0123134160, Fax : +2 050 2243220

Received: 2011-08-15 DOI:10.5430/jst.v1n3p112

Accepted: 2011-10-11 Published: 2011-11-23 URL: http://dx.doi.org/10.5430/jst.v1n3p112

Abstract Background Hilar cholangiocarcinoma (HCCA) is a challenging problem for surgeons because surgery is the only effective therapy for these patients. In this study, we review 15 years of HCCC cases and treatment at a single Egyptian center. Methods From January 1995 to October 2010, 825 patients with HCCC were referred to Gastroenterology Surgical Center, Mansoura University, Egypt. From those 243 underwent potentially curative resection giving respectability rate of 29.4%, and the remaining patients (70.6%) underwent non-surgical treatment because of advanced disease, advanced cirrhosis, poor general condition and distant metastasis and locally advanced diseases. Data were recorded for the 243 cases (subjected to different types of hepatic resection), including demographics, medical history, presenting symptoms, and biochemical, radiological, and pathological parameters. Results The overall resectability rate of the patients studied was 29.4% (243/825). Localized resection, right hepatectomy, or left hepatectomy were completed in 30.5%, 22.6%, and 46.9% respectively, and segment one in 58 % R0 status was achieved in 49.8% of patients. The overall complication rate was 35%. Operative mortality was 6.6% with a five-year survival rate of 16%. Recurrence occurred in 92 (37.8%) the site of recurrence was hepatic (24.3%) and local (13.5%). Resection margin (R0) (P