Erschienen in:
01.10.2006
Hepatectomy for Colorectal Liver Metastases with Macroscopic Intrabiliary Tumor Growth
verfasst von:
Teiichi Sugiura, MD, Masato Nagino, MD, Koji Oda, MD, Tomoki Ebata, MD, Hideki Nishio, MD, Toshiyuki Arai, MD, Yuji Nimura, MD
Erschienen in:
World Journal of Surgery
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Ausgabe 10/2006
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Abstract
Objectives
We set out to clarify the clinicopathologic characteristics of colorectal liver metastases with macroscopic intrabiliary tumor growth and to determine optimal surgical management.
Methods
Over 15 years, 6 of 103 patients undergoing hepatectomy for colorectal liver metastases had macroscopic intrabiliary tumor growth and were analyzed retrospectively.
Results
We performed 11 operations for the 6 patients, consisting of 10 hepatectomies (including 1 hepatopancreatoduodenectomy) and 1 pancreatoduodenectomy. Three patients survived more than 5 years: 1 died of pulmonary emphysema with no sign of recurrence 101 months after initial hepatectomy; the 2 others were alive with no sign of recurrence at 74 and 145 months after initial hepatectomy. Median survival time of all 6 patients was 87.5 months. Histologically, intrabiliary tumor growth had two components: intraluminal and intraepithelial extension. In the proximal direction, distance between these two components ranged from 4–10 mm.
Conclusion
Aggressive surgical treatment can improve chances of long-term survival for patients with macroscopic intrabiliary growth of colorectal liver metastasis. Although nonanatomic limited resection is a common procedure for colorectal liver metastasis, anatomic hepatobiliary resection is recommended.