{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T17:55:10Z","timestamp":1771955710509,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T00:00:00Z","timestamp":1476921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T00:00:00Z","timestamp":1476921600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"name":"the MiaoPu Youth Fund","award":["2015MP002"],"award-info":[{"award-number":["2015MP002"]}]},{"name":"the National Clinical Key Specialty Construction Project (General Surgery) of China"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Aggressive hepatectomy is effective in treating intrahepatic stones and may minimize the deleterious consequences of subsequent cholangiocarcinoma (S\u2010CCA). The risk factors of S\u2010CCA after different methods of hepatectomy may vary with the resection scope of stone\u2010affected segments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the records of 981 patients of primary intrahepatic stones with elective hepatectomy from January 2000 to December 2010. The clinical characteristics of patients in the S\u2010CCA group (<jats:italic>n<\/jats:italic> = 55) and the control group (<jats:italic>n<\/jats:italic> = 926) were compared. The uniformity between extent of liver resection (ELR) with stone\u2010affected segments (SAS) was segmented into 2 varieties: ELR = SAS with ELR &lt; SAS according to the different hepatic resection scopes. Cox regression model with forward selection was used to identify the risk factors of S\u2010CCA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the univariate analysis, significant differences were observed between the S\u2010CCA and control groups concerning stone location (unilateral 43.6 and 65.2 %, bilateral 56.4 and 34.8 %), residual stones (32.7 and 11.6 %), hepaticojejunostomy (43.6 and 30.9 %), and uniformity between ELR with SAS (ELR = SAS 20.0 and 42.6 %, ELR &lt; SAS 80.0 and 57.4 %). Residual stones [hazard ratio (HR) 2.101, <jats:italic>P<\/jats:italic> = 0.016], hepaticojejunostomy (HR 1.837, <jats:italic>P<\/jats:italic> = 0.026) and uniformity between ELR and SAS (HR 2.442, <jats:italic>P<\/jats:italic> = 0.013) were independent prognostic factors for S\u2010CCA by a Cox regression analysis with forward selection. In the subsection of ELR = SAS group, the 5\u2010 and 10\u2010year postoperative tumor occurrence rates of unilateral and bilateral stones group were 0.9 versus 1.9 % and 3.0 versus 4.1 %, respectively (<jats:italic>P<\/jats:italic> = 0.663, log\u2010rank). In the other subsection of ELR &lt; SAS group, the 5\u2010 and 10\u2010year postoperative tumor occurrence rates of unilateral and bilateral stones group were 3.4 versus 3.9 % and 6.8 versus 13.2 %, respectively (<jats:italic>P<\/jats:italic> = 0.047, log\u2010rank), and the 5\u2010 and 10\u2010year postoperative tumor occurrence rates of residual stones and non\u2010residual stones group were 5.8 versus 3.0 % and 16.0 versus 7.9 %, respectively (<jats:italic>P<\/jats:italic> = 0.015, log\u2010rank).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients who underwent aggressive hepatectomy and had ELR = SAS had better outcomes than those with ELR &lt; SAS. In the patients with ELR = SAS, the S\u2010CCA rates of unilateral and bilateral stones were low and comparable. However, patients with ELR &lt; SAS and bilateral intrahepatic or residual stones should be monitored more carefully for high\u2010risk factors of S\u2010CCA.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-016-3752-2","type":"journal-article","created":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T16:13:37Z","timestamp":1476980017000},"page":"835-843","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Risk Factors for Cholangiocarcinoma After Initial Hepatectomy for Intrahepatic Stones"],"prefix":"10.1002","volume":"41","author":[{"given":"Ze\u2010Wu","family":"Meng","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery The Affiliated Union Hospital of Fujian Medical University 29 Xinquan Road 350001 Fuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng\u2010Hua","family":"Han","sequence":"additional","affiliation":[{"name":"Department of 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