Comparative Analysis of Left- Versus Right-sided Resection in Klatskin Tumor Surgery: can Lesion Side be Considered a Prognostic Factor?

Francesca Ratti, Federica Cipriani, Guglielmo Piozzi, Marco Catena, Michele Paganelli, Luca Aldrighetti

Research output: Contribution to journalArticle

Abstract

Background: Achievement of negative margins is the goal of curative intent surgery for hilar cholangiocarcinoma. This study analyzed factors affecting survival in hilar cholangiocarcinoma patients and compared short- and long-term outcomes of left- and right-sided resections. Methods: One hundred and five patients out of 124 diagnosed with Klatskin tumors underwent major liver resection. Sixty-one patients underwent right-sided resections (right group), whereas 44 underwent left-sided resections (left group). Perioperative morbidity, perioperative mortality, and overall and disease-free survival were compared between the groups. Results: Morbidity and mortality were higher in the right group (59 and 8.2 %, respectively) than in the left group (38.6 and 2.3 %, respectively) (p <0.005). The most frequent cause of death was liver failure. The R0 rate was 75.4 % in the right and 61.4 % in the left group. The 5-year survival rate was 42.8 % in the right and 35.3 % in the left group (p <0.05). Patients in the left group more frequently developed local recurrence (87 vs. 69 % in the right group). Conclusion: Lesion side impacts outcome: right resections still cause significant morbidity related to extensive parenchymal sacrifice but are associated with better long-term survival because right hepatic pedicle resection enables better radicality compared with left resections.

Original languageEnglish
Pages (from-to)1324-1333
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume19
Issue number7
DOIs
Publication statusPublished - May 8 2015

Keywords

  • Hilar cholangiocarcinoma
  • Left hepatectomy
  • Liver surgery
  • R0 resection
  • Right hepatectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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