Prognostic Factors for Bile Leak and Long-Term Survival in 23 Patients with Klatskin Type III Tumors

Author Info

Antoine R. El Asmar Christina Abou-Malhab Elie Ghabi Toufic Saber Bernard Akl Ziad El Rassi

Corresponding Author

Antoine R. El Asmar
Fellow in Digestive Surgery and Surgical Oncology, Institut Jules Bordet, Brussels, Belgium

A B S T R A C T

Objective: Surgical resection of hilar cholangiocarcinoma carries significant morbidity and mortality, particularly if postoperative bile leak occurs. Prognostic factors and scoring tools have been described for overall morbidity and mortality but none are specific for postoperative bile leak. In this study, we investigate the prognostic utility of various factors in predicting overall morbidity, mortality and risk of biliary leak in Bismuth Type III tumors with the hopes of developing a scoring tool in future research. Materials and Methods: A retrospective sample of 23 patients with Bismuth Type III tumors exclusively who underwent surgery between 2010 and 2017 were selected for this study. Demographic, surgical, pathologic and biochemical data were collected from the patients’ medical records. Results: 11 patients underwent a right hepatectomy for type IIIa tumors and 10 patients underwent a left hepatectomy for type IIIb tumors. 2 patients were lost to follow up and were excluded. R0 resection was achieved in 20 patients. Overall survival at 1, 3 and 5 years was 78.3%, 61.9% and 38.1%, respectively. A BMI >24kg/m2 was associated with a worse prognosis, increased overall morbidity and decreased survival at 1, 3 and 5 years (p<0.05). A preoperative creatinine >0.74 was associated with decreased 5-year survival (p<0.05). Conclusion: A BMI >24kg/m2 and a preoperative creatinine >0.74 are associated with a poor prognosis in Bismuth Type III Klatskin tumors. Furthermore, Age, sex, preoperative hemoglobin, tumor size, use of CUSA and type IIIb tumors demonstrate a borderline significant association with the occurrence of postoperative bile leak.

Article Info

Article Type

Research Article

Publication history

Received: Wed 21, Oct 2020
Accepted: Thu 05, Nov 2020
Published: Mon 23, Nov 2020

Copyright

© 2023 Antoine R. El Asmar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.COR.2020.11.03