Results after resection of hilar cholangiocarcinoma

Hilar cholangiocarcinoma has been known as a cancer with low resectability and poor survival; consequently, palliative stenting has often been proposed as the first line of treatment If all patients were stented without knowledge of the extent of their cancer and potential resectability, some patients may be denied a chance for long term survival. In our series of patients with hilar cholangiocarcinoma, long term survival was observed in those resected with negative margins and even in those with carcinoma-in-situ (CIS) at the margin. Patients with infiltrative cancer at margins also had significantly better survival than unresected patients. In those patients without significant co-morbid factors, every effort must be undertaken to stage their cancer pre and intraoperatively. Those patients with less than stage IV disease should be considered for aggressive surgical resection, including combined bile duct and liver resection, if necessary.