| Theme | Malignant Biliary Stricture -- Recent Advancements on Diagnosis & Treatment | |
|---|---|---|
| Title | Surgical Therapy for Biliary Malignancy | |
| Publish Date | 2014/08 | |
| Author | Takashi Mizuno | Department of Surgical Oncology, Nagoya University Graduate School of Medicine |
| Author | Tomoki Ebata | Department of Surgical Oncology, Nagoya University Graduate School of Medicine |
| Author | Yukihiro Yokoyama | Department of Surgical Oncology, Nagoya University Graduate School of Medicine |
| Author | Takeshi Ikami | Department of Surgical Oncology, Nagoya University Graduate School of Medicine |
| Author | Hajime Sugawara | Department of Surgical Oncology, Nagoya University Graduate School of Medicine |
| Author | Junpei Yamaguchi | Department of Surgical Oncology, Nagoya University Graduate School of Medicine |
| Author | Masato Nagino | Department of Surgical Oncology, Nagoya University Graduate School of Medicine |
| [ Summary ] | Surgical resection is the only promising therapy for the cure of biliary malignancies. Pancreaticoduodenectomy or major hepatic resection with extrahepatic bile duct resection is indicated as the standard procedure, depending on tumor location. Recent advances in surgical techniques and knowledge have increased the number of procedures available. These include bilateral trisectionectomy, combined portal vein resection, combined portal vein and hepatic artery resection, as well as hepatopancreaticoduodenectomies, which are being adapted to treatment of an extensive range of diseases. In leading hepatobiliary centers, patientsʼ postoperative courses are reported on and it is decided if treatment was acceptable compared with that provided in unresectable cases. Even if the patients undergo R0 resection, their long term survival may still be unsatisfactory. While efficacious adjuvant treatment regimens are under development, at this time, there is no promising regimen being tested in prospective phase III randomized trials. Some meta-analysis has shown the efficacy of adjuvant chemoand chemoradiotherapy in the R1 or nodes of positive patients. With improvement being made in more promising regimens, more patients may undergo surgery for locally advanced, initially unresectable conditions. |
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