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Right trisectionectomy of the liver for intrahepatic cholangiocarcinoma with bile duct invasion in a Jehovah's Witness
Author(s) -
Nishida Seigo,
Madariaga Juan R.,
Santiago Sergio,
Quintini Cristiano,
Palaios Emmanouil,
Gyamfi Anthony,
Rico Rafael,
Hamamura Keisuke,
Haider Hani,
Moon Jang I.,
Levi David M.,
Casillas Victor J.,
Bejarano Pablo A.,
Tzakis Andreas G.
Publication year - 2007
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/s00534-006-1143-z
Subject(s) - medicine , hepatectomy , intrahepatic cholangiocarcinoma , hepatolithiasis , bile duct , dissection (medical) , surgery , blood transfusion , liver transplantation , malignancy , general surgery , transplantation , resection
Intrahepatic cholangiocarcinoma (ICC) is well known to have a very poor prognosis. Aggressive surgical strategies in the treatment of ICC, including major hepatectomy, have been reported to afford patients the best chance for significant survival. Recent advancements in surgical techniques concerning live donor liver transplantation have dramatically improved the results of major hepatectomy. However, surgical treatment of biliary malignancy is complex and is known to increase the likelihood of blood transfusion. We describe a Jehovah's Witness patient with ICC and concomitant bile duct invasion who had a successful right trisectionectomy with bile duct resection, lymph node dissection, and Rouxen‐Y hepatico‐jejunostomy without blood transfusion. A multidisciplinary preparation was crucial in obtaining this positive outcome. Importantly, bloodless liver transection techniques with inflow clamping, meticulous dissection, and hemostasis should be utilized for major hepatectomy in a Jehovah's Witness. The success of this case may alert clinicians to consider a hepatectomy as a possible option in the treatment of ICC in a Jehovah's Witness.