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Standardisation of Decision Making in Hilar Cholangiocarcinoma Management: A Case Series
Correspondence Address :
Dr. Pradeep Joshua Christopher,
GEM Hospital and Research Institute, Pankaja Mills Road, Ramanathapuram, Coimbatore-641023 Tamil Nadu, India.
E-mail: pdp.joshua@gmail.com
Hilar Cholangiocarcinoma (CCA) is a very complex disease that requires the best multidisciplinary decisions. Improved outcomes are reported only in high-volume centres with good expertise and the latest technology in radiology for imaging and intervention, endoscopy, and surgery. However, in India, only very few centres have very good infrastructure for the same. Additionally, protocol-driven treatment is also not uniform in India. To fulfil this gap, authors believe that a strict, disciplined work-up of these complex cases is the only way to achieve optimal treatment. Authors propose a protocolised checklist involving multidisciplinary decisions for hilar CCA patients that could be used. This case series aims to assess the oncological outcome of hilar CCA using our checklist and, secondarily, to assess the immediate postoperative outcome and complications in these patients. Out of 20 patients, 13 underwent successful hepatectomy based on the decisions made. No mortality was noted in this case series. Two cases had a postoperative liver failure (Clavien Dindo 3A). All 13 patients had an R0 resection. The mean length of the tumour-free margin was 8.46 mm. Doing two-dimensional surgical simulation preoperatively and adhering to the special plane of transection helped in attaining R0 resection. Here, a small series of hilar CCA is presented which was managed successfully, signifying the importance of a protocol-based approach which can be easily adapted and reproduced.
Future liver remnant, Hilar stricture, Resection, Treatment protocol
DOI: 10.7860/JCDR/2024/69317.19451
Date of Submission: Dec 28, 2023
Date of Peer Review: Feb 21, 2024
Date of Acceptance: Apr 04, 2024
Date of Publishing: May 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Dec 28, 2023
• Manual Googling: Mar 29, 2024
• iThenticate Software: Apr 01, 2024 (7%)
ETYMOLOGY: Author Origin
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