Guidelines for Resection of Intrahepatic Cholangiocarcinoma

Abstract

Intrahepatic cholangiocarcinoma is a disease of the biliary tree that is increasing in incidence. Etiologic factors include hepatolithiasis, cirrhosis, hepatitis, and steatosis. Many patients often present with advanced disease, and a subset will be surgical candidates. Resection is the treatment of choice and offers the best chance at long-term survival. An R0 margin should be obtained. At the time of surgery, lymph node evaluation should be performed as lymph node status strongly correlates with prognosis. Other factors associated with prognosis include tumor number and size as well as the presence of vascular invasion. The incidence of recurrence following resection is high. As such, adjuvant systemic chemotherapy should be considered especially among those patients with ICC tumors that have high-risk features.