The Importance Of Surgeon's Experience In Klatskin Tumor

Surgical resection provides the only chance of a cure for this disease. Still, it is technically challenging because of this location's complex, intimate, and variable relationship between biliary and vascular structures.

The surgical treatment of perihilar cholangiocarcinoma (Klatskin tumor) can be successful when the following aspects have been fulfilled:

accurate preoperative diagnosis aimed to identify the tumor in all its details (localization and extension) and to study all the risk factors influencing a post hepatectomy liver failure: i.e., liver volume, liver function, liver quality, hemodynamics, and patient characteristics;

High-end surgical skills taking into consideration the local extension of the tumor and the vascular invasion, which usually require an extended hepatic resection and often a vascular resection;

Adequate postoperative management aimed to avoid significant complications (i.e.posthepatectomy liver failure and biliary complications). These are technically challenging operations and must be performed in high-volume centers by hepato-biliary-pancreas surgeons with experience in microsurgical vascular techniques.