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Clinical Benefit of Frozen Section of Proximal Bile Duct Margin in Perihilar Cholangiocarcinoma
( Lakkana Adireklarpwong ),( Sunhawitjunrungsee ),( Anon Chotirosniramit ),( Trichak Sandhu ),( Worakitti Lapisetepun ),( Tidarat Jirapongcharoenlap ),( Kamtone Chandacham ),( Kamtone Chandacham ),( N 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: R0 resection is the best chance of prolonging the survival of cholangiocarcinoma patients. Frozen section analysis of duct margin often be used to determine bile duct in an attempt to achieve R0 resection, but the clinical benefit remains controversial. Methods: All 132 patients underwent hepatectomy for perihilar cholangiocarcinoma between January 2006, and December 2019 were analyzed into prospective and retrospective group. Resection status, the accuracy of the frozen section, surgical variables, prognostic factors, survival, and recurrence were evaluated. Results: R0 status in frozen section group was higher than non-frozen section group but not significant (48.72 vs 35.48 percent) (P=0.175). Median survival in both groups were 24 and 17 months that tend to be better in frozen section group although there were no statistically significant difference (P=0.25). And one-year survival rates were 65.38 and 67.57 percent. In all populations, the median survival of R0 resection patients was better than R1 resection patients (32 vs 13 months) (P=0.001). However, median survival of secondary R0 and R1 resection was not different (P=0.43). The median follow up time in frozen section and non frozen section group were 19.12 and 77.67 months. Conclusions: The clinical benefit of the frozen section of the proximal bile duct margin is still inconclusive. Intraoperative frozen section analysis tends to increase the number of R0 resection and prolong survival, although they were not significant. The frozen section should be done if possible for increasing R0 resection rate that has better survival.
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