TY - JOUR
AR - COR-2020-11-103
TI - Prognostic Factors for Bile Leak and Long-Term Survival in 23 Patients with Klatskin Type III Tumors
AU - Antoine R. , El Asmar
AU - Christina , Abou-Malhab
AU - Elie , Ghabi
AU - Toufic , Saber
AU - Bernard , Akl
AU - Ziad El , Rassi
JO - Clinical Oncology and Research
PY - 2020
DA - Mon 23, Nov 2020
SN - 2613-4942
DO - http://dx.doi.org/10.31487/j.COR.2020.11.03
UR - https://www.sciencerepository.org/prognostic-factors-for-bile-leak-and-long-term-survival-in_COR-2020-11-103 
KW - Klatskin tumor, hilar cholangiocarcinoma, hepatectomy, biliary surgery
AB - 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.