• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Minimally Invasive Approaches to Intrahepatic and Extrahepatic Cholangiocarcinoma

Andrew A Gumbs, MD, Nicolas Jarufe, MD, Brice Gayet, MD PhD. Summit Medical Group, Pontificia Universidad Católica School of Medicine, Institut Mutualiste Montsouris

 

Introduction: Due to the perceived difficulty in dissecting hilar cholangiocarcinomas off of the portal structures and in performing complex biliary reconstructions, very few centers have used minimally invasive techniques for these tumors. Furthermore, due to the relative rarity of this tumor when compared to hepatocellular carcinoma, only a few reports have focused on short and long-term results for intrahepatic cholangiocarcinoma.

Methods: Because of this, a review was undertaken by combining the experience of 3 international centers with expertise in complex minimally invasive hepatobiliary surgery. Patients were entered into a database retrospectively, all patients with cholangocarcinoma were analyzed. Patients were divided into hilar cholangiocarcinomas and intrahepatic cholaniocarcinomas. The Bismuth classification was used to stratify the hilar cholangiocarcinomas.

Results: From December 2002- June 2011, a total of 14 patients were resected laparoscopically for cholangiocarcinoma. Nine patients had an intrahepatic lesion. Their mean age was 69 years (range= 48-86 years). Three patients (75%) required an extended major hepatectomy, 4 a major hepatectomy and 2 underwent minor hepatectomies. Eight patients with intrahepatic disease were stage I with 1 patient having stage II disease. This last patient had 3 lesions in segment IVb and had an R2 resection. Of the remaining patients, 7 had R0 resections with a final patient found to have R1 disease on final pathology. The mean resection margin was 11mm (range= 0-30mm). The median size of lesions resected was 67 mm (range= 30-70mm). The mean estimated blood loss (EBL) was 233 mL (range= 100-400mL). The median length of stay (LOS) was 11 days (range=6-21 days). Six out of 9 patients are currently alive with a median follow-up of 28 months. Five patients had a hilar lesion, their mean age was 73 years (range= 66-79 years). These patients had stage IIa (2 patients), IIIa, IIIb and IV, respectively. One of these patients (20%) was converted to an open procedure due to concerns for portal vein involvement. The patient with stage IV disease had an R1 resection on final pathology all other patients had R0 resections. The mean EBL was 240 mL (range=0-400 mL), the median LOS was 15 days (range=11-21 days). All patients are currently alive with a median follow up of 11 months (range= 3-18 months). None of the 14 patients developed port site recurrences. No patients required reoperation, but 2 patients developed bile leaks and a final patient developed a pulmonary embolism for an overall morbidity rate of 21%. The overall conversion rate was 7%. There were no mortalities at 30 or 90 days.

Discussion: Minimally invasive approaches for both intrahepatic and hilar cholangiocarcinomas appear feasible and safe. There is no increased rate of port site recurrences when cholangiocarcinomas are removed laparoscopically. Although short term results seem similar to the published open experience, longer-term follow-up is needed to see how disease free and overall survival is affected.
 


Session Number: SS03 – HPB (Hepatobiliary and Pancreas)
Program Number: S015

127

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons