Survival outcomes of hepatic resections in Bismuth-Corlette type IV cholangiocarcinoma

Dominic Ku*, Reuben Tang, Tony Pang, Henry Pleass, Arthur Richardson, Lawrence Yuen, Vincent Lam

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    8 Citations (Scopus)


    Background: Surgical resection for Bismuth-Corlette type IV (BC-IV) hilar cholangiocarcinomas, also termed Klatskin tumours are technically challenging and were once considered unresectable tumours. Following advances in hepatobiliary imaging and surgical techniques, emerging evidence suggests that surgical resection is a viable avenue for long-term survival. We aimed to identify factors affecting survival outcomes of hepatic resections for BC-IV cholangiocarcinomas. Method: A systematic review was performed across multiple databases and several clinical trial registries. Two reviewers independently screened and selected papers that contained survival data on BC-IV cholangiocarcinoma after hepatic resections. Results: Of 13 499 papers from our search result, 21 papers satisfied the inclusion criteria. The median post-operative survival was 30.8 months. The average 1- and 5-year post-operative survivals were 61.6 and 33.3%, respectively. Predictors of long-term survival included achievement of R0 margins, minimisation of operative time and reduction intra-operative blood loss. Conclusion: Our analysis demonstrates improving post-operative outcomes and survival in surgical resection of BC-IV cholangiocarcinoma and suggests that radical surgical resection is a valid treatment option for the disease.

    Original languageEnglish
    Pages (from-to)1604-1614
    Number of pages11
    JournalANZ Journal of Surgery
    Issue number9
    Early online date15 Dec 2019
    Publication statusPublished - Sept 2020


    • bile duct neoplasm
    • cholangiocarcinoma
    • hepatectomy
    • hilar carcinoma
    • survival outcome


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