Abstract
Background
Hepatectomy combined with hepatic artery reconstruction in the operation for hilar cholangiocarcinoma (Klatskin tumor) is a challenging procedure. We present a video of left hepatectomy combined with right hepatic artery reconstruction for hilar cholangiocarcinoma.
Patient and Methods
The patient was a 60-year-old male who presented with obstructive jaundice. The imaging examination showed that the confluence of left and right hepatic ducts and the wall of common hepatic duct were thickened, the local lumen was narrowed, the intrahepatic bile duct was dilated, and the right hepatic artery was invaded by tumors nearly 2.3 centimeters. Left hepatectomy with total caudate lobectomy, resection with reconstruction of right hepatic artery, hilar lymphadenectomy, and Roux-en-Y hepaticojejunostomy were performed.
Results
The operation time was 345 min, and the amount of bleeding was about 400 ml. There was no blood transfusion. The pathology showed poorly differentiated adenocarcinoma, with negative margins of common bile duct and right hepatic duct, and negative results of all lymph nodes. The patient’s recovery was uneventful and he was discharged on postoperative day 14. The patient was disease free at 12-month follow-up evaluation.
Conclusions
Hepatic artery resection and reconstruction procedure is safe and feasible for hilar cholangiocarcinoma in a highly tertiary hepatobiliary center.
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Ethical Approval
The studies involving human participants were reviewed and approved by the medical ethics committee of the First Affiliated Hospital of Guangxi Medical University, Guangxi, China.
Author contributions
Z.J. and B.X. collected data and wrote the manuscript. W.C., K.H., and Z.L. made substantial contributions to the conception of the work. L.Z. and T.L. provided the patient’s imaging data. H.Z., Z.W., H.Z., and Y.G. provided critical revisions for important intellectual content. Z.W. was responsible for ensuring accuracy and integrity and finalized the article. All authors contributed to the article and approved the submitted version.
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Zhang, J., Xu, B., Chen, W. et al. Left Hepatectomy Combined with Right Hepatic Artery Resection and Reconstruction for Hilar Cholangiocarcinoma. Ann Surg Oncol 31, 3086 (2024). https://doi.org/10.1245/s10434-024-14948-z
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DOI: https://doi.org/10.1245/s10434-024-14948-z