Tumor de Klatskin: tratamiento quirúrgico / Klatskin tumor: surgical treatment

Desde 1985 a junio de 1991, 13 de 15 pacientes (87//) con colangiocarcinoma hiliar fueron resecados. La resección completa se logró en 9, (69//) de las resecciones y al 60// de los pacientes remitidos. Se efectuaron 3 resecciones locales amplias y 6 que además necesitaron de resecciones hepáticas mayores. En 4 casos se incluyó la resección del lóbulo caudado y en 2 fueron necesarias resecciones parciales de la vena porta remanente. En las resecciones completas (9) la morbilidad fue del 55,5// y la mortalidad del 22,2//. Los completamente resecados sobrevivieron entre 13 y 50 meses. Los otros entre 3 y 13 meses. Un paciente con una forma papilar temprana lleva 30 meses libres de síntomas. Todos los fallecidos tuvieron recidiva local y 3 metástasis a distancia. La resección completa del tumor brinda la mayor supervivencia y de mejor calidad

Segment III by-pass for palliation of cholangio carcinoma

Segment III by - pass was tried in 12 patients presented with Jaundice and diagnosed as cholangiocarcinoma at hilum of the liver with PTC and ERCP, 6 males and 6 females. All patients had contraindication to resection by PTC finding [bilateral ductal extension beyond second order ducts]. The procedure was completed in 11 patients. There was one death in the 5th postoperative day in patient in whom there was failure to achieve by-pass due to renal failure. Self controlled biliary fistula happened in 3 patients. Persistent Jaundice postoperatively in one patient, most probably due to improper choice of the patient suitable for that procedure. Cholangitis occured in 4 patients resolved with antibiotic except in one patient who died in 35th postoperative day. As regard long term results, 8 patients have been followed until death with an average survival from 2-24 months. Recurrence of Jaundice and biliary infection were the most common long term complication before death