Table 3.
Criteria that can be used to identify non-resectable patients
| Absolute criteria |
Relative criteria |
|
| Criteria | Suggestions | |
| Presence of distant metastasis (especially liver, lung, peritoneum) | Longitudinal and lateral dissemination | Consider adequate staging (avoid R1-2) |
| Extra-regional lymphnode involvement (para-aortic and extraperitoneal) | ||
| Bilateral intrahepatic involvement of biliary tree that exclude bilio-enteric anastomosis | Portal infiltration < 2 cm | Portal vein resection needed |
| Infiltration or occlusion of the main portal trunk proximal to bifurcation | ||
| Right lobe atrophy associated to contralateral portal vein infiltration or portal occlusion > 2 cm | Low remant liver | Consider liver hypertrophy techniques |
| Right lobe atrophy associated to contralateral tumor extension more than to 2 cm from hepatic hilum | ||
| Contralateral invasion of hepatic artery | Type IV pCCC | High expertise; consider en-bloc resection |
| Unilobar secondary bile ducts invasion associated to contralateral infiltration or collusion of portal vein | ||
pCCC: Perihilar cholangiocarncioma.