Surgically difficult tumor
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Hi Kasia,
Sorry to hear that you are a recently diagnosed patient. In regards to difficult to resect tumors, some surgeons are more skillful and more willing to operate than others. You should send your scans to a 2nd or 3rd opinion with surgeons who deal with cholangiocarcinoma a lot to see if it is truly unresectable. In response to your question about the ex vivo surgery, I know Dr. Kato at Columbia/NY Presbyterian has done them for other liver cancers, but I’m not sure if they have performed any on a cholangiocarcinoma patient. I think the NY Times had a write up about it, but I believe that patient only survived for about a year post op.
Good luck in your treatments!
Hi Kasia,
Welcome to the discussion board.
Your question sent me looking as I had not been aware of this form of liver surgery for cholangiocarcinoma. There is always something new to learn about.
The surgery you describe seems to go by a number of names, including “liver autotransplant,” “ex vivo hepatectomy with autotransplantation” and “ex situ liver resection,” (as well as variations of these terms) for purposes of internet searching if anyone is interested in learning more.
This is a very uncommon form of resection where the liver is removed from the body, resected to remove the tumor(s), then part of the liver is returned to the patient – as you describe, it is like a living donor partial liver transplant except the living donor is the patient himself (or herself). It has been used for cases of liver cancer or metastasis where the location of the cancer in the liver makes a more standard resection infeasible.
One article I saw described this surgery as the most complex liver surgery available. It is described as high risk, has rigorous criteria for patient eligibility, and demands a level of surgeon skill only available at very experienced liver transplant centers. So few of these operations are performed that there do not seem to be much long-term data yet on patient outcomes, although there are individual cases of good results.
Gavin recently posted an article on this type of surgery on this board – here is the citation.
https://www.ncbi.nlm.nih.gov/pubmed/29022283
Please let us know if you learn more about this procedure, and how you are doing in your path to treatment. There is a great and welcoming community of patients and caregivers here, and we learn from one another.
Regards, Mary
I have recently been diagnosised with cholangiocarcinoma and have a tumor within the liver in a place close to blood vessels which makes surgery very difficult or not an option. The tumor is 5.3 CM by 3.8 CM. it is a primary tumor. Has anyone heard of a method that takes the liver out, takes the tumor out, and re-transplants the liver into the patient? You are the receptive to find your own liver transplant.
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