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Professor Bernard Launois Department of Surgery University of Rennes
CLASSIFICATION OF EXTRA-HEPATIC BILE DUCT CANCER
 
Two questions ,[object Object],[object Object]
Preoperative biliary drainage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Infectious postoperative complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
 
Portal embolisation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Surgical techniques ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Aims of laparoscopy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Overall Yield and accuracy of dedecting irresectable cancer ,[object Object],[object Object],[object Object],[object Object]
Surgical findings precluding resection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Preserved venous allografts ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
 
Patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Location ,[object Object],[object Object],[object Object],[object Object],[object Object]
PROXIMAL BILE DUCT CANCER OPERATIVE PROCEDURES ACCORDING TO TUMOR LOCATION Correlation coefficient rho = 0,6695 p < 0,01
OPERATIVE PROCEDURES ACCORDING TO TNM CLASSIFICATION Correlation coefficient rho = 0,4133 p < 0,01
PROXIMAL BILE DUCT CANCER OPERATIVE PROCEDURES ACCORDING TO TNM STAGING Correlation coefficient rho = 0,4926 p < 0,01
Operative mortality according  to surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Resectability ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Klatskin Tumor Overall survival Month
Klatskin Tumor Survival according to age Month years > 60 years < 60-70 years
Klatskin Tumor Survival according to histology Month Noudular Infiltrant Papillomatosis
Klatskin Tumor Survival according to location
Klatskin Tumor Survival according to TNM classification Month
Klatskin Tumor Survival according to lymph node involvement
Klatskin Tumor Survival according to liver metastases Month Month
Klatskin Tumor Survival according to TNM staging Month
Klatskin Tumor Survival according to type of surgery Month Tumor resection Transplantation Hepatic and vascular resection Hepatectomy
Cirrhosis : 21571 Cancers : 4046 Acute hepatic failure : 3483 Patient Survival according to the Indication 01/1988 - 06/2001 62 66 71 75 81 37 42 49 57 74 55 56 58 60 64 0 20 40 60 80 100 1 2 3 4 5 6 7 8 9 10 (%) Yrs Total Log Rank test p = 0.0001 p Log Rank : Acute Hepatic Failure vs Cirrhosis : 0.0001 Cancers vs Cirrhosis : 0.0001 Acute Hepatic Failure vs Cancers : 0.0001 (Wilcoxon test)
 
 
 
Survival ,[object Object],[object Object],[object Object],[object Object]
Long term survivors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

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