Surgical resection of hepatic hilum cancers

Perihilar cholangiocarcinoma is an aggressive tumor originating from the bile duct epithelium, for which surgical resection is the only curative treatment possible. The location of the tumor often renders resectability complicated, necessitating frequent vascular reconstructions. Preoperative hepatic optimization is crucial for optimal postoperative outcomes and patient survival. The tumor's local extension requires meticulous preoperative assessment of resectability to optimize the chances of achieving R0 surgical margins. The quality of resection is pivotal for long-term patient survival.
Lastly, liver transplantation is considered a potential treatment for PHC limited to the liver, in young patients, with no possibility of resection due to extensive local extension or underlying hepatopathy. Transplantation is preceded by "neoadjuvant" treatment involving radiotherapy, brachytherapy, and chemotherapy.