BACKGROUND: Colorectal liver metastases (CRLMs) with biliary invasion can be treated with a combined liver and extrahepatic bile duct resection. The aim of this study was to analyze outcomes of this procedure in a case-cohort analysis and systematic review. METHODS: Consecutive patients who underwent a major liver resection for CRLM between 2003 and 2013 were selected from a single center prospective database, comparing patients with and without biliary invasion. A specific and a general search strategy were used to identify relevant articles in the systematic review. RESULTS: Ten patients (13.2%) underwent combined liver and extrahepatic bile duct resection for CLRM with biliary invasion, among 76 patients included. An R0 resection was achieved in five of ten patients (50%); one of ten patients died postoperatively. Median overall survival was 19 months among patients with biliary invasion, versus 106 months among patients without biliary invasion (P=0.12). The systematic review yielded a large variability in 5-year survival after resection of CLRM with biliary invasion, ranging between 33-80%. CONCLUSIONS: Surgical resection of CLRM with central biliary invasion is feasible, but survival in these patients tends to be lower due to a high rate of non-radical resections.
BACKGROUND:Colorectal liver metastases (CRLMs) with biliary invasion can be treated with a combined liver and extrahepatic bile duct resection. The aim of this study was to analyze outcomes of this procedure in a case-cohort analysis and systematic review. METHODS: Consecutive patients who underwent a major liver resection for CRLM between 2003 and 2013 were selected from a single center prospective database, comparing patients with and without biliary invasion. A specific and a general search strategy were used to identify relevant articles in the systematic review. RESULTS: Ten patients (13.2%) underwent combined liver and extrahepatic bile duct resection for CLRM with biliary invasion, among 76 patients included. An R0 resection was achieved in five of ten patients (50%); one of ten patients died postoperatively. Median overall survival was 19 months among patients with biliary invasion, versus 106 months among patients without biliary invasion (P=0.12). The systematic review yielded a large variability in 5-year survival after resection of CLRM with biliary invasion, ranging between 33-80%. CONCLUSIONS: Surgical resection of CLRM with central biliary invasion is feasible, but survival in these patients tends to be lower due to a high rate of non-radical resections.
Authors: T M van Gulik; J J Kloek; A T Ruys; O R C Busch; G J van Tienhoven; J S Lameris; E A J Rauws; D J Gouma Journal: Eur J Surg Oncol Date: 2010-11-27 Impact factor: 4.424
Authors: Robbert J de Haas; Dennis A Wicherts; Paola Andreani; Gérard Pascal; Faouzi Saliba; Philippe Ichai; René Adam; Denis Castaing; Daniel Azoulay Journal: Ann Surg Date: 2011-06 Impact factor: 12.969
Authors: F Rassam; E Roos; K P van Lienden; J E van Hooft; H J Klümpen; G van Tienhoven; R J Bennink; M R Engelbrecht; A Schoorlemmer; U H W Beuers; J Verheij; M G Besselink; O R Busch; T M van Gulik Journal: Langenbecks Arch Surg Date: 2018-01-19 Impact factor: 3.445