[Role of minimally invasive interventions in the treatment of complications caused by recidive Klatskin tumors].

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  • Additional Information
    • Transliterated Title:
      Minimálisan invazív beavatkozások szerepe a recidív Klatskin-tumorok szövódményeinek ellátásában.
    • Source:
      Publisher: Akademiai Kiado Country of Publication: Hungary NLM ID: 0376412 Publication Model: Print Cited Medium: Print ISSN: 0030-6002 (Print) Linking ISSN: 00306002 NLM ISO Abbreviation: Orv Hetil Subsets: MEDLINE
    • Publication Information:
      Publication: 2007- : Budapest : Akademiai Kiado
      Original Publication: Pest : Markusovszky Lajos
    • Subject Terms:
      Hepatic Duct, Common*/surgery ; Minimally Invasive Surgical Procedures*; Bile Duct Neoplasms/*complications ; Esophageal and Gastric Varices/*surgery ; Gastric Outlet Obstruction/*surgery ; Jaundice, Obstructive/*surgery ; Klatskin Tumor/*complications ; Liver Abscess/*surgery ; Neoplasm Recurrence, Local/*surgery; Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms/surgery ; Drainage/methods ; Esophageal and Gastric Varices/etiology ; Female ; Gastric Outlet Obstruction/etiology ; Humans ; Jaundice, Obstructive/etiology ; Klatskin Tumor/surgery ; Liver Abscess/etiology ; Male ; Middle Aged ; Retrospective Studies ; Sclerotherapy/methods
    • Abstract:
      Background: The hilar cholangiocarcinoma grows slowly and gives metastases very rarely. The first prominent sign of this cancer is the jaundice. In spite of the small size of the tumour, oncologically radical resection is only feasible--owing to the anatomical position--in approximately 35-50% of the cases. This makes recidivity frequent. The recidive cancer involves the hilus of the liver, compresses the surrounding organs and develops different complications.
      Methods: 37 patients underwent surgical resection in the 1st Surgical Department of Semmelweis University in the last ten years. Complete tumour-free surgical margins were found in only 48.6% of the cases. The mean follow-up was 23.2 (8-47) months.
      Results: 9 patients were treated for complication caused by local recurrence. These were mechanical jaundice (9 cases), bleeding oesophageal varices (2 cases), gastric outlet obstruction (2 cases), liver abscess (3 cases) and pain caused by the infiltration of the coeliac ganglion (3 cases). Most part of the complication could be solved by minimal invasive therapy (percutane transhepatic endoprosthesis or drainage, endoscopic sclerotherapy, ultrasound-guided drainage, percutane blockade of the celiac ganglion).
      Conclusions: The fact that resected patients may survive several years as long as patients treated with endoprosthesis and irradiation only survive half a year, has brought a change in the way Klatskin cancer surgery is considered: resection of the tumour should be striven for--even by way of R1 resection. Therefore the risk of recurrence will increase. This is the first article in the literature, which has ever dealt with the complication caused by recidive cancer after resection of Klatskin tumour.
    • Publication Date:
      Date Created: 20040117 Date Completed: 20040316 Latest Revision: 20151119
    • Publication Date:
      20221213
    • Accession Number:
      14725049