In the high hilar resection group (HHR) there were 21patients. In the liver resection group (LR) there were 24 patients. The negative surgical margins in the bile.
E-HPBA: Free Prize Papers after multiple prior attempts following the injury in community hospitals and twenty-six (24%) patients with minor injuries were treated only with interventional techniques etc. ERCP, PTC. The predicted probability of sepsis was revealed with the number and type of the prior attempts (OR:3, OR: 10.1) before referral to Ege University School of Medicine. The multiple log. regression analyse of the factors significantly determined a distinctive correlation between the Clavien- Dindo classification system and sepsis (Corrected odds: 4.6 CI: 1.56e13.8). In the final model; the presence of abscess formation (OR:5.4), concomitant vascular injury (OR: 11.8) and the level of biluribin in blood (OR:14.7) were significantly effective for mortality. Conclusions: The sepsis status and Clavien- Dindo grading system correctly relates the prognosis. The presence of abscess formation, vascular injury and biluribin levels in the referral are the potential risk factors. The initial clinical approach has to be determined in the light of predictive factors that are effective on morbidity and mortality.
BILIARY 0630 SURGICAL STRATEGY FOR HILAR CHOLANGIOCARCINOMA. HIGH HILAR RESECTION VERSUS HEPATECTOMY? O. V. Unalp, K. Erozkan, A. Uguz, M. Sozbilen and A. Coker Ege University School of Medicine, Turkey Aims: Surgical resection is the only option for long term survival in patients with hilar cholangiocarcinoma The aim of the present study is to investigate the survival, morbidity and mortality difference between the different surgical modalities Methods: 45 patients with pathologically confirmed diagnosis of hilar cholangiocarcinoma were enrolled in the study. Data of the 45 enrolled patients which were performed a curative surgery for hilar cholangiocarcinoma between 2008e2014 at Ege University School of Medicine were analysed retrospectively. Patients were classified into two groups. In the high hilar resection group (HHR) there were 21patients. In the liver resection group (LR) there were 24 patients. The negative surgical margins in the bile duct was confirmed as negative by frozen section for both groups. The demographic data of the patients, pathological ana anatomical features of the tumor and overall survival time were analysed retrospectively. Results: Of the 21 patients of HHR group 14 were male and 7 were female with the mean age of 62,6 (range 45e 83). Of the 24 patients of the LR group 15 were male and 9 were female with the mean age of 61,1 (range 51e84). Right hepatectomy was the hepatic resection type that was performed in 6 patients where left hepatectomy was performed in 11 and segment 4be5 resection was performed in 7 patients. Perioperative mortality occured in 1 patients due to septic complication in HHR group and in 4 patients in LR group due to liver failure. The average tumor size was 2.96 cm (0,5e7 cm) in HHR group where 3,5 cm (0,8e7,5 cm) in LR group. The average overall survival time was calculated as 18 months in HHR group and 12,4 months in LR group.
HPB 2016, 18 (S2), e670ee684
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Conclusions: High hilar resection should be kept in mind as a strategy to avoid the postoperative liver failure in patients with hilar cholangiocarcinoma.
BILIARY 0640 RESECTABILITY OF PERIHILAR CHOLANGIOCARCINOMAS F. Bartsch, J. Baumgart, S. Heinrich and H. Lang The Hospital of the Johannes Gutenberg-University, Germany Aims: The preoperative evaluation of perihilar cholangiocarcinomas is very difficult. For its therapy often major hepatic resections are necessary as well as resection and reconstruction of the hepatic artery or the portal vein. In the last centuries great advances were made in the surgical procedures and perioperative anaesthetic management. We want to describe which facts are from our point of view the limit for curative (R0-) resection of perihilar cholangiocarcinoma. Methods: Retrospective data of a 6 year period (2008e 2014) was collected in a SPSS 22 database and further analysed with focus on the surgical approach as well as the postoperative course and histological results. Results: Out of 96 patients in total we were able in 73 patients (76%) to intend a curative resection. In 59/73 (81%) resections a R0-situation could be reached (R1 n = 14; R2 n = 1). 23 patients were irresectable because of peritoneal carcinosis (n = 8), broad infiltration of major blood vessels (n = 8), bilateral spread to the intrahepatic bile ducts (n = 3), infiltration of the complete liver hilum (n = 2), infiltration of the gall bladder (n = 1) and liver cirrhosis (n = 1). Patients with a T4-stadium were treated with curative intention twice and in each case a R1-resection was achieved. Most irresectable patients can be suspected as T4-stadium as well. In a T3-situation (n = 6) we could establish five R0- and one R1-resections. Conclusions: The limit of surgical resection for perihilar cholangiocarcinoma is the advanced tumor stage (T-stadium). While in a T3-stadium in most cases a R0-sesection is possible we were not able to perform a R0-resection in a T4-stadium. From our point of view the T-stadium cannot be estimated through expanded diagnostic but only through surgical exploration.
BILIARY 0659 OUTCOME FOLLOWING RESECTION OF BILIARY CYSTADENOMA: A SINGLE CENTRE EXPERIENCE M. Pitchaimuthu, G. Aidoo-Micah, C. Coldham, R. P. Sutcliffe, K. J. Roberts, P. Muiesan, J. Isaac, D. F. Mirza and R. Marudanayagam University Hospitals of Birmingham NHS Foundation Trust, UK Aims: Biliary cystadenoma (BCA) are rare, benign, potentially malignant cystic lesions of the liver, accounting for less than 5% of cystic liver tumours. These lesions have potential for recurrence and malignant transformation. The aim of the study was to analyse the outcome following resection of biliary cystadenoma from a single tertiary centre. Methods: Patients who had resection of BCA between 1993 and 2014 (21 years) were included in the study. The
