HYPOTHESIS: In operations for @entity201 , simultaneous extended hepatectomy and removal of extrahepatic bile ducts are considered curative resection. However, the effect of extended operations for stage IV @entity201 on survival is still unclear. DESIGN: Retrospective review of the treatment of @entity201 from 1981 to 2001. @entity1 AND METHODS: Fifty-seven @entity1 with stage IVA or IVB @entity201 were enrolled. Thirty-three of these @entity1 underwent extended hepatectomy to achieve macroscopic radical resection (surgical group). A self-expandable metallic biliary stent (EMBS) was implanted in 24 @entity1 (EMBS group) in whom radical treatment was judged to be impossible. Main Outcome Measure Survival in @entity1 with stage IV @entity201 treated by means of extended operation or stenting. RESULTS: Survival was 25.7 +/- 40.9 months in the surgical group vs 6.5 +/- 5.8 months in the EMBS group (P =.03). In the surgical group, radical resection results were macroscopically and histologically successful in 21 @entity1 (64%). In @entity1 with stage IVB disease, survival did not differ between the surgical and EMBS groups. CONCLUSIONS: In @entity1 with @entity3480 , radical extended hepatectomy should be performed after excluding @entity1 who have extensive @entity99 or portal vein. However, in @entity1 with stage IVB disease with @entity298 or distant metastasis, there is little possibility of achieving long-term survival with surgery, and stent implantation should be the first choice.

Indications for extended hepatectomy in the management of stage IV XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity3480 :: ('MESH:C538167', 'Disease') :: ['stage IVA disease'] @entity201 :: ('MESH:D018281', 'Disease') :: ['hilar cholangiocarcinoma'] @entity99 :: ('MESH:D056486', 'Disease') :: ['invasion of the hepatic artery'] @entity298 :: ('MESH:D010538', 'Disease') :: ['carcinomatous peritonitis']
@entity201 :: (MESH:D018281,Disease) :: ['hilar cholangiocarcinoma']
