Abstract
Background
Minimally invasive surgery for perihilar cholangiocarcinoma (pCCA) is in an exploratory phase by now and is only recommended for carefully selected patients.
Patients and Methods
Our team performed total laparoscopic hepatectomy in a 64-year-old woman with perihilar cholangiocarcinoma type IIIb. Laparoscopic left hepatectomy and caudate lobectomy were performed involving a no-touch en-block technique. Meanwhile, extrahepatic bile duct resection, radical lymphadenectomy with skeletonization, and biliary reconstruction were performed.
Results
Laparoscopic left hepatectomy and caudate lobectomy were successfully performed in 320 min with 100 ml of blood loss. The histological grading was T2bN0M0 (stage II). The patient was discharged on the 5th day without postoperative complications. Following the operation, the patient received single-drug capecitabine chemotherapy. There was no recurrence after 16 months of follow-up.
Conclusion
Our experience is that, in selected patients with pCCA type IIIb or type IIIa, laparoscopic resection can reach comparable outcome to open surgery with standardized lymph node dissection by skeletonization, use of no-touch en-block technique, and proper digestive tract reconstruction.
Similar content being viewed by others
References
National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology. [cited 2023 January 30th]; Available from: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1438.
Nishio H, Nagino M, Nimura Y. Surgical management of hilar cholangiocarcinoma: the Nagoya experience. HPB (Oxford). 2005;7(4):259–62.
Jarnagin WR, et al. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma. Ann Surg. 2001;234(4):507–17.
Liu S, et al. Application of laparoscopic radical resection for type III and IV hilar cholangiocarcinoma treatment. Gastroenterol Res Pract. 2020;2020:1506275.
Li J, et al. Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center. Wideochir Inne Tech Maloinwazyjne. 2021;16(1):62–75.
Sucher R, Scheuermann U, Seehofer D. Total laparoscopic resection of hilar cholangiocarcinoma type 3b: Applying a parachute technique for hepaticojejunostomy. Ann Surg Oncol. 2021;28(4):2030–4.
Ma D, et al. Laparoscopic versus open surgery for hilar cholangiocarcinoma: a retrospective cohort study on short-term and long-term outcomes. Surg Endosc. 2022;36(6):3721–31.
Cipriani F, et al. Laparoscopic versus open major hepatectomy: Analysis of clinical outcomes and cost effectiveness in a high-volume center. J Gastrointest Surg. 2019;23(11):2163–73.
Belghiti J, Ogata S. Preoperative optimization of the liver for resection in patients with hilar cholangiocarcinoma. HPB (Oxford). 2005;7(4):252–3.
Weber SM, et al. Staging laparoscopy in patients with extrahepatic biliary carcinoma. Analysis of 100 patients. Ann Surg. 2002;235(3):392–9.
Giulianotti PC, et al. Robot-assisted laparoscopic extended right hepatectomy with biliary reconstruction. J Laparoendosc Adv Surg Tech A. 2010;20(2):159–63.
Yu H, et al. Laparoscopic resection of Bismuth type I and II hilar cholangiocarcinoma: an audit of 14 cases from two institutions. Dig Surg. 2011;28(1):44–9.
Lee W, et al. Laparoscopic resection of hilar cholangiocarcinoma. Ann Surg Treat Res. 2015;89(4):228–32.
Giuliante F, et al. Association of lymph node status with survival in patients after liver resection for hilar cholangiocarcinoma in an Italian multicenter analysis. JAMA Surg. 2016;151(10):916–22.
De Lu C, et al. Total hilar en bloc resection with left hemihepatectomy and caudate lobectomy: a novel approach for treatment of left-sided perihilar cholangiocarcinoma (with video). J Gastrointest Surg. 2017;21(11):1906–14.
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
DISCLOSURE
All authors have no conflicts of interest or financial to disclose.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Supplementary file1 (MP4 264741 kb)
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Wen, N., Gao, W., Hu, H. et al. Laparoscopic Resection of Perihilar Cholangiocarcinoma Type IIIb: A Video Demonstration of No-Touch En-Block Technique and Radical Lymphadenectomy. Ann Surg Oncol 30, 4871–4873 (2023). https://doi.org/10.1245/s10434-023-13552-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1245/s10434-023-13552-x