Strategic International Session3(JSGS・JSGE・JSH)
Sat. November 4th   9:00 - 11:30   Room 9: Portopia Hotel Main Building Kairaku 3
The current situation of hilar cholangiocarcinoma and the possibility of liver transplantation
Akihiro Seki1, Shintaro Yagi2, Taro Yamashita1
1Gastroenterology, Kanazawa University, 2Hepatobiliary Pancreatic and Transplant Surgery, Kanazawa University
Background: Liver transplantation is expected to be a fundamental treatment for hilar cholangiocarcinoma; however, not covered by Japanese public insurance. The current medical condition of hilar cholangiocarcinoma must be evaluated to expand the indication.
Methods: In this study, we retrospectively examined the background, treatments, and prognosis of hilar cholangiocarcinoma patients from 2006 to 2022 in our institute. We also examined the backgrounds of patients who met the criteria for the advanced medicine "Living donor liver transplantation for unresectable hilar cholangiocarcinoma.".
Results: Of the 92 hilar cholangiocarcinoma cases, 32 were resectable, and 60 were unresectable. The unresectable reason was metastasis (16 cases), local progression (38 cases), and intolerance (9 cases) (duplicates). The median survival of the 40 cases treated with chemotherapy was 20.2 months. In the 25 resectable patients whose postoperative pathology could be evaluated, HM0/DM0 resection was obtained in 10 cases (40%). Of the 10 cases, 8 (80%) were performed after 2020, when cholangioscopic diagnosis was innovated at our institute. Of the unresectable patients, 11 cases (12%) could be considered for liver transplantation. One patient underwent living donor liver transplantation.
Conclusion: The diagnosis using new-generation cholangioscopy was conducted to increase accuracy and result in higher curative resection. Approximately 10% of hilar cholangiocarcinoma patients might be eligible for liver transplantation. Therefore, the treatment plan, including liver transplantation, must be carefully considered in younger patients.
Index Term 1: liver transplantation
Index Term 2: cholangiocarcinoma
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