Objective. To estimate the immediate and late results of surgical treatment in patients, suffering peripheral cholangiocarcinoma with invasion of visceral vein.
Маterials and methods. Retrospective analysis was accomplished for surgical treatment of 84 patients, suffering peripheral cholangiocarcinoma, in whom radical operations were performed in Department of Transplantation and Hepatic Surgery of Shalimov National Istitute of Surgery and Transplantology in a period from Jan. 2004 tо Dec. 2018 yrs. The investigated group consisted of 28 patients, to whom hepatic resection with simultant resection and plasty of visceral veins for tumoral vascular invasion was performed. Into comparison group 56 patients were included, in whom hepatic resection was not accompanied with vascular resection.
Results. Trustworthy differences were absent between groups in accordance to following indices: the patients’ age (p=0.16-0.7), gender (p=0.3), physical status (p=0.36), pre- and postoperative stationary stay (p=0.4). In the investigated group there were performed 14.3% hemihepatectomies, 32.1% extended hemihepatectomies and 53.6% threesectioectomies, and in a comparative one - 57.2% (р ≤ 0.001), 14.3% (р = 0.054) and 21.4% (р = 0.002), accordingly. Simultant intervention on biliary ducts was done in 37.5% patients from investigated group and in 25% patients from comparative group (р = 0.305), the adjacent organs resection - in 14.3 and 12.5% (р = 0.819) patients, accordingly. Clinically significant postoperative complications were observed in 25 and 30.4% (р = 0.262) patients, accordingly. In the investigated group postoperative mortality was absent, while in a comparative one it constituted 3.5%. In the investigated group a 3-years and a 5-years total survival was noted in 47 and 35% patients, accordingly, while in a comparison group - in 49% (р = 0.317) and 38% (р = 0.003) patients, accordingly. In investigated group a 3-years and a 5-years survival without a recurrence was noted in 39 and 28% patients, accordingly, and in a comparative group - in 44% (р = 0.04) and 31% (р=0.002) patients, accordingly.
Conclusion. Іnvasion of peripheral cholangiocarcinoma into visceral veins does not constitute a contraindication for operative treatment, if it is conducted in a highly specialized multidisciplinary centre.