A successfully resected case of left trisectionectomy with arterio-portal combined resection for advanced cholangiocarcinoma
| Autor: | Masahide Hiyoshi, Koichi Yano, Naoya Imamura, Atsushi Nanashima, Takeomi Hamada, Rouko Hamada, Hiroshi Ito, Teru Chiyotanda, Kenzo Nagatomo |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
education 030230 surgery Anastomosis digestive system Article Preoperative examination Aggressive surgery 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases medicine Perihilar Cholangiocarcinoma Abscess Severe complication Combined resection business.industry respiratory system medicine.disease digestive system diseases Surgery Plastic surgery 030211 gastroenterology & hepatology Left trisectionectomy Combined vascular resection business Careful managements |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2018.10.036 |
| Popis: | Highlights • In case of cholangiocarcinoma invading hilar vessels, adequate simulations and expert skills are required to achieve R0 resection. Introduction The present case report demonstrated the successfully radical operation (R0) for the highly advanced cholangiocarcinoma involving hilar hepatic arteries and portal vein, The careful preoperative diagnosis to define the adequate resection area and the expert operation was achieved without postoperative severe complications. Presentation of case A 55-year-old male was admitted to our hospital with obstructive jaundice, and the perihilar cholangiocarcinoma (PC) was found. At the time of finding PC, enhanced computed tomography showed the widely extension and involved the surrounding right hepatic artery (RHA) and bilateral portal veins (PV). According to extension of PC, left trisectionectomy combined resection of RHA and PV trunk was scheduled. By supporting plastic surgeon’s procedure, the scheduled R0 operation could be achieved and the patient was discharged without any severe complication but delayed intrahepatic abscess formation. After abscess drainage, he could immediately recovered and tumor relapse was not observed for a couple of months. By carefully preoperative examination, a complicated operation was successfully completed. Discussion The major hepatectomy with arterio-portal resections and anastomosis for advanced has been challenged at the high-volume center and the improvement of survival seemed to be obtained and, however, operative risk is still remained. This operation could be achieved by the expert surgeons under precise planning or management. Conclusion The role of HBP surgeons is to challenge aggressive surgery even for patients with highly advanced local extension of PC. |
| Databáze: | OpenAIRE |
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