1. Prognostic analysis of surgical treatment of peripheral cholangiocarcinoma: Two decades of experience at Chang Gung Memorial Hospital Yi-Yin Jan, Chun-Nan Yeh, Ta-Sen Yeh, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, China Tse-Ching Chen, Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, China World J Gastroenterol 2005;11(12):1779-1784

2. Introduction Peripheral cholangiocarcinoma(PCC) Ophithorchis viverrini, Clonorchis sinensis, hepatolithiasis, PSC, choledochal cysts, Caroli’s disease. Difficult to diagnose in its early stage Vague symptoms Curative resection : infrequent Reccurence Radiation therapy, chemotherapy does not improve long term survival rate Early intrahepatic and extrahepatic spread To analyze the prognostic factors influencing the overall survival of PPC patients undergoing surgical treatment

3. Material and Methods 1997.1 - 2001.12 373 pts. underwent surgery  312 pts. enrolled Curative resection : negative resection margin observed during histopathologic examination Surgical mortality rate : death occuring within one month after surgery CA19-9, CEA US, ERCP, percutaneous transhepatic cholangiography, CT, MRCP, hepatic ahgiography TNM system Stage I, II –early stage / Stage III, IV –advanced stage Adjuvant chmo : 5FU / Adjuvant radiotherapy

4. Results

10. 1 2 3 4 5

12. Conclusion Long term survival of PCC pts. Undergoing surgical treatment depends on early tumor stage, presence of mucobilia, papilary tumor type, hepatic resection, and post-op chemotherapy