Document Detail

Hepatic artery reconstruction first for the treatment of hilar cholangiocarcinoma bismuth type IIIB with contralateral arterial invasion: a novel technical strategy.
MedLine Citation:
PMID:  22151454     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: En-bloc liver resection with the extrahepatic bile duct is mandatory to obtain tumour-free surgical margins and better long-term outcomes in hilar cholangiocarcinoma (CC). One of the most important criteria for irresectability is local extensive invasion to major vessels. As hilar CC Bismuth type IIIB often requires a major left hepatic resection, the invasion of the right hepatic artery (RHA) usually contraindicates this procedure.
METHODS: The authors describe a novel technique that allowed an oncological resection in two patients with hilar CC Bismuth type IIIB and contralateral arterial invasion. Arterial reconstruction between the posterior branch of the RHA and the left hepatic artery (LHA) was performed as the first surgical step. Once arterial vascular flow was restored, a left trisectionectomy with caudate lobe resection and portal vein reconstruction was performed.
RESULTS: In both patients an R0 resection was achieved. Both patients made a full recovery and were discharged within 14 days of surgery. Both patients remain free of disease at 18 months.
CONCLUSIONS: This new technique allows a R0 resection to be achieved in patients with Bismuth type IIIB hilar CC with contralateral arterial involvement.
Eduardo de Santibañes; Victoria Ardiles; Fernando A Alvarez; Juan Pekolj; Claudio Brandi; Axel Beskow
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2011-10-23
Journal Detail:
Title:  HPB : the official journal of the International Hepato Pancreato Biliary Association     Volume:  14     ISSN:  1477-2574     ISO Abbreviation:  HPB (Oxford)     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-14     Completed Date:  2012-05-01     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  100900921     Medline TA:  HPB (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  67-70     Citation Subset:  IM    
Copyright Information:
© 2011 International Hepato-Pancreato-Biliary Association.
Hospital Italiano de Buenos Aires, General Surgical Service, Argentina.
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MeSH Terms
Bile Duct Neoplasms / pathology,  surgery*
Bile Ducts, Intrahepatic*
Cholangiocarcinoma / pathology,  surgery*
Follow-Up Studies
Hepatic Artery / pathology,  surgery*
Middle Aged
Neoplasm Staging
Reconstructive Surgical Procedures / methods*
Vascular Neoplasms / pathology,  surgery*
Vascular Surgical Procedures / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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