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Kovalenko Yu.A.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Makarchev A.D.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Muhtarov O.Ya.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Shevchenko T.V.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Ruzavin V.S.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Gurmikov B.N.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Long-term postoperative outcomes in patients with hilar cholangiocarcinoma: a single-center experience

Authors:

Kovalenko Yu.A., Makarchev A.D., Muhtarov O.Ya., Shevchenko T.V., Ruzavin V.S., Gurmikov B.N.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2026;(3): 18‑24

DOI: 10.17116/hirurgia202603118

Read: 773 times

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LONG-TERM POSTOPERATIVE OUTCOMES IN PATIENTS WITH HILAR CHOLANGIOCARCINOMA: A SINGLE-CENTER EXPERIENCE
LONG-TERM POSTOPERATIVE OUTCOMES IN PATIENTS WITH HILAR CHOLANGIOCARCINOMA: A SINGLE-CENTER EXPERIENCE

To cite this article:

Kovalenko YuA, Makarchev AD, Muhtarov OYa, Shevchenko TV, Ruzavin VS, Gurmikov BN. Long-term postoperative outcomes in patients with hilar cholangiocarcinoma: a single-center experience. Pirogov Russian Journal of Surgery. 2026;(3):18‑24. (In Russ.)
https://doi.org/10.17116/hirurgia202603118

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
Recommended articles:
Pare­nchyma-preserving surgical treatment option for a patient with Klatskin tumor with atypical anatomy of hilus stru­ctures. P.A. Herzen Journal of Onco­logy. 2025;(4):75-81
Abstract:

OBJECTIVE

To evaluate long-term postoperative outcomes in patients with hilar cholangiocarcinoma.

MATERIAL AND METHODS

This study included patients with hilar cholangiocarcinoma who underwent primary surgery at the Vishnevsky National Research Center of Surgery. Exclusion criteria: surgery outside our hospital, death within 90 days after surgery, distant metastases and combined hepatocellular carcinoma. Extent of surgery was determined by modern guidelines. Comparison groups included patients with different resection statuses. Statistical analysis was performed using STATISTICA 13 software.

RESULTS

The study included 92 patients (60 men (65.2%) and 32 women (34.8%)). Age ranged was from 18 to 83 years. Patients underwent resection of the common bile duct (13 (14.1%) cases), hemihepatectomy with bile duct resection (55 (59.8%) cases); extended hemihepatectomy with bile duct resection (16 (17.4%) cases), resection of extrahepatic bile ducts combined with PDE (1 (1.1%) case). In 32 (38.5%) cases, regional lymph node involvement was noted. We assessed all loci of tumor invasion in longitudinal and radial resection margins, as well as excised regional lymph nodes. According to our classification, resection status was as follows depending on the number of R+ loci and lymph node assessment: R0 — 7 (8.75%), R+1 — 2 (2.5%), R+2 — 7 (8.75%), R+3 — 3 (3.75%), R+4 — 6 (7.5%), R+5 — 14 (17.5%), R+6 — 21 (25.25%), R+7 — 20 (25%), respectively. According to multivariate analysis, significant factors of unfavorable prognosis were TNM stage (p=0.006), tumor cells in lymph nodes (p=0.01), differentiation grade (p=0.02) and perineural invasion (p=0.03). Overall 1-, 3-, 5-, 7- and 10-year survival rates were 70%, 30%, 18%, 16%, and 16%, respectively. Survival significantly differed between R0 and R+1—7 resection groups (p=0.01).

CONCLUSION

Resection of extrahepatic bile ducts is radical for Bismuth-Corlette types I-II. Extensive liver resections are indicated for types III-IV. To assess resection quality, it is important to consider “clearness” of true resection margin, taking into account all loci of invasion. According to this approach, 5-year survival rate after R0 or R+1—2 resection is 100%.

Keywords:

portal cholangiocarcinoma
Klatskin tumor
Bismuth-Corlette
resection margin
bile duct resection

Authors:

Kovalenko Yu.A.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Makarchev A.D.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Muhtarov O.Ya.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Shevchenko T.V.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Ruzavin V.S.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Gurmikov B.N.

Vishnevsky National Research Center of Surgery, Moscow, Russia

Received:

18.04.2025

Accepted:

26.12.2025

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