Achieving negative margin in Bismuth III and IV hilar cholangiocarcinoma without major hepatectomy
Keywords:Hilar cholangiocarcinoma; Liver resection; Negative margin
Background: Several studies have proposed en bloc resection with major hepatectomy to achieve negative margin in hilar cholangiocarcinoma. These major hepatectomy have morbidity in some subgroups of patients with limited functional hepatic reserve.
Methodology: Patients with Bismuth type III and IV hilar cholangiocarcinoma with underlying early cirrhosis that underwent liver parenchymal preserving bilobar wedge liver resection between July 2017 to June 2020 were included in the study.
Results: Twelve patients underwent liver parenchymal preserving bilobar wedge liver resection between July 2017 to June 2020. Mean age of the study population was 70.83±3.58 years. Reconstruction of biliary tree was done with intrahepatic cholangiojejunostomy in Roux en Y fashion in multiple segmental hepatic stomas.
Conclusion: Liver parenchymal preserving surgery should be considered in hilar cholangiocarcinoma in selected cases to prevent suspicion increasing morbidity and mortality due to post-operative liver failure.
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