Cancers, Vol. 13, Pages 3735: Vascular Involvements in Cholangiocarcinoma: Tips and Tricks

Cancers, Vol. 13, Pages 3735: Vascular Involvements in Cholangiocarcinoma: Tips and Tricks Cancers doi: 10.3390/cancers13153735 Authors: Roberta Angelico Bruno Sensi Alessandro Parente Leandro Siragusa Carlo Gazia Giuseppe Tisone Tommaso Maria Manzia Cholangiocarcinoma (CCA) is an aggressive malignancy of the biliary tract. To date, surgical treatment remains the only hope for definitive cure of CCA patients. Involvement of major vascular structures was traditionally considered a contraindication for resection. Nowadays, selected cases of CCA with vascular involvement can be successfully approached. Intrahepatic CCA often involves the major hepatic veins or the inferior vena cava and might necessitate complete vascular exclusion, in situ hypothermic perfusion, ex situ surgery and reconstruction with autologous, heterologous or synthetic grafts. Hilar CCA more frequently involves the portal vein and hepatic artery. Resection and reconstruction of the portal vein is now considered a relatively safe and beneficial technique, and it is accepted as a standard option either with direct anastomosis or jump grafts. However, hepatic artery resection remains controversial; despite accumulating positive reports, the procedure remains technically challenging with increased rates of morbidity. When arterial reconstruction is not possible, arterio-portal shunting may offer salvage, while sometimes an efficient collateral system could bypass the need for arterial reconst...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research