{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T04:54:32Z","timestamp":1758862472086,"version":"3.41.2"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Biliary tract cancers (BTCs) have limited response to systemic therapy and poor prognosis. Immunotherapy in BTCs has been investigated in recent years. Here, we report a case of locally advanced, unresectable gallbladder adenocarcinoma that progressed on chemotherapy. The patient was then treated with ipilimumab and nivolumab, which resulted in tumor shrinkage and autoimmune hepatitis, but established technical resectability. He underwent complete resection through extended right hepatectomy with en bloc cholecystectomy bile duct resection, hepatic and portal lymphadenectomy and Roux-Y hepaticojejunostomy reconstruction. The final pathology revealed a pathologic complete response. The scope of operative intervention after immunotherapy is still evolving for BTCs. Establishing resectability in tumors not susceptible to cytotoxic agents but responding to immunotherapy not only facilitates curative intent resection but also enhances the importance of infection prevention through operative stent-free long-term biliary decompression. Immunotherapy may also carry a unique risk profile for post-operative morbidity potential as in this case with autoimmune hepatitis.<\/jats:p>","DOI":"10.1093\/jscr\/rjab414","type":"journal-article","created":{"date-parts":[[2021,9,19]],"date-time":"2021-09-19T11:06:58Z","timestamp":1632049618000},"source":"Crossref","is-referenced-by-count":5,"title":["A case from the future of HPB surgical oncology: resection of biliary tract cancer after immunotherapy"],"prefix":"10.1093","volume":"2021","author":[{"given":"Vikas","family":"Satyananda","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Chouliaras","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonid","family":"Cherkassky","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roderich E","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"issue":"Suppl 7","key":"2021103110025233700_ref1","doi-asserted-by":"crossref","first-page":"vii 345","DOI":"10.1093\/annonc\/mdq420","article-title":"Advances in the treatment of metastatic or unresectable biliary tract cancer","volume":"21","author":"Valle","year":"2010","journal-title":"Ann Oncol"},{"key":"2021103110025233700_ref2","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s11605-006-0018-6","article-title":"Lymph node dissection impact on staging and survival of extrahepatic cholangiocarcinomas, based on U.S. population data","volume":"11","author":"Schwarz","year":"2007","journal-title":"J Gastrointest Surg"},{"key":"2021103110025233700_ref3","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1056\/NEJMoa0908721","article-title":"Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer","volume":"362","author":"Valle","year":"2010","journal-title":"N Engl J Med"},{"key":"2021103110025233700_ref4","first-page":"1454","article-title":"Targeting cholangiocarcinoma","volume":"2018","author":"Mertens","year":"1864","journal-title":"Biochim Biophys Acta Mol basis Dis"},{"key":"2021103110025233700_ref5","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1056\/NEJMoa1500596","article-title":"PD-1 blockade in tumors with mismatch-repair deficiency","volume":"372","author":"Le","year":"2015","journal-title":"N Engl J Med"},{"key":"2021103110025233700_ref6","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1080\/17474124.2021.1853527","article-title":"Recent advances of immunotherapy for biliary tract cancer","volume":"15","author":"Rizzo","year":"2021","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"2021103110025233700_ref7","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1001\/jamaoncol.2020.2814","article-title":"Evaluation of combination nivolumab and ipilimumab immunotherapy in patients with advanced biliary tract cancers: subgroup analysis of a phase 2 nonrandomized clinical trial","volume":"6","author":"Klein","year":"2020","journal-title":"JAMA Oncol"},{"key":"2021103110025233700_ref8","doi-asserted-by":"crossref","DOI":"10.3390\/cancers13071569","article-title":"Immunotherapy in advanced biliary tract cancers","volume":"13","author":"Boil\u00e8ve","year":"2021","journal-title":"Cancers (Basel)"},{"key":"2021103110025233700_ref9","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1001\/jamaoncol.2020.0930","article-title":"A phase 2 multi-institutional study of nivolumab for patients with advanced refractory biliary tract cancer","volume":"6","author":"Kim","year":"2020","journal-title":"JAMA Oncol"},{"key":"2021103110025233700_ref10","doi-asserted-by":"crossref","first-page":"5293","DOI":"10.2147\/OTT.S197559","article-title":"Completely resolved advanced biliary tract cancer after treatment by pembrolizumab: a report of two cases","volume":"12","author":"Alshari","year":"2019","journal-title":"Onco Targets Ther"},{"key":"2021103110025233700_ref11","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/hep.31227","article-title":"Hepatotoxicity from immune checkpoint inhibitors: a systematic review and management recommendation","volume":"72","author":"Peeraphatdit","year":"2020","journal-title":"Hepatology"},{"key":"2021103110025233700_ref12","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1136\/flgastro-2018-101146","article-title":"Immunotherapy-related hepatitis: real-world experience from a tertiary centre","volume":"10","author":"Cheung","year":"2019","journal-title":"Frontline Gastroenterol"},{"key":"2021103110025233700_ref13","doi-asserted-by":"crossref","first-page":"2508","DOI":"10.1007\/s11605-019-04430-7","article-title":"Impact of preoperative cholangitis on short-term outcomes among patients undergoing liver resection","volume":"24","author":"Sahara","year":"2020","journal-title":"J Gastrointest Surg"},{"key":"2021103110025233700_ref14","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s005340200009","article-title":"Technical considerations to maintain a low frequency of postoperative biliary stent-associated infections","volume":"9","author":"Schwarz","year":"2002","journal-title":"J Hepato-Biliary-Pancreat Surg"},{"key":"2021103110025233700_ref15","doi-asserted-by":"crossref","first-page":"2951","DOI":"10.1007\/s00268-018-4546-5","article-title":"Prognostic impact of bacterobilia on morbidity and postoperative management after pancreatoduodenectomy: a systematic review and meta-analysis","volume":"42","author":"M\u00fcssle","year":"2018","journal-title":"World J Surg"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jscr\/article-pdf\/2021\/10\/rjab414\/40836009\/rjab414.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jscr\/article-pdf\/2021\/10\/rjab414\/40836009\/rjab414.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T10:07:07Z","timestamp":1635674827000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjab414\/6409724"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,1]]},"references-count":15,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjab414","relation":{},"ISSN":["2042-8812"],"issn-type":[{"type":"electronic","value":"2042-8812"}],"subject":[],"published-other":{"date-parts":[[2021,10]]},"published":{"date-parts":[[2021,10,1]]},"article-number":"rjab414"}}