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. 2020 Jul 7;26(25):3542–3561. doi: 10.3748/wjg.v26.i25.3542

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.