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Anterior approach for right hepatectomy for hilar cholangiocarcinoma
Author(s) -
Liu ChiLeung,
Fan SheungTat
Publication year - 2003
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-002-0812-9
Subject(s) - hepatectomy , medicine , surgery , portal vein , sepsis , biliary tract , mobilization , adhesion , resection , chemistry , archaeology , organic chemistry , history
Background/Purpose Right hepatectomy is indicated for hilar cholangiocarcinoma, but mobilization of the right lobe could be difficult when perihepatic adhesion develops in response to repeated cholangitis and forceful mobilization may disseminate bacteria if the obstructed biliary tract contains pus. We encountered a patient who died from postoperative sepsis and multiorgan failure. Methods To circumvent such a difficulty, we employed the anterior approach right hepatectomy in a second patient with hilar cholangiocarcinoma. In this patient, liver transection and division of the hepatic vein were performed before mobilization of the right lobe. Results The second patient recovered uneventfully. Conclusion The anterior approach (utilizing the “no‐touch” technique) may be a preferred procedure for right hepatectomy for hilar cholangiocarcinoma.