Langenbeck's Archives of Surgery

, Volume 398, Issue 8, pp 1145–1150

Isolated caudate lobectomy with pancreatoduodenectomy for a bile duct cancer

  • Tsuyoshi Sano
  • Yasuhiro Shimizu
  • Yoshiki Senda
  • Koji Komori
  • Seiji Ito
  • Tetsuya Abe
  • Taira Kinoshita
  • Yuji Nimura
How-I-Do-It article

DOI: 10.1007/s00423-013-1110-5

Cite this article as:
Sano, T., Shimizu, Y., Senda, Y. et al. Langenbecks Arch Surg (2013) 398: 1145. doi:10.1007/s00423-013-1110-5

Abstract

Background

In patients with distal bile duct cancer involving the hepatic hilus, a major hepatectomy concomitant with pancreatoduodenectomy (HPD) is sometimes ideal to obtain a cancer-free resection margin. However, the surgical invasiveness of HPD is considerable.

Patients and methods

We present our treatment option for patients with distal bile duct cancer showing mucosal spreading to the hepatic hilum associated with impaired liver function. To minimize resection volume of the liver, an isolated caudate lobectomy (CL) with pancreatoduodenectomy (PD) using an anterior liver splitting approach is presented. Liver transection lines and bile duct resection points correspond complete with our standard right and left hemihepatectomies with CL for perihilar cholangiocarcinoma.

Results

Total operation time was 765 min, and pedicle occlusion time was 124 min, respectively. Although the proximal mucosal cancer extension was identified at both the right and the left hepatic ducts, all resection margins were negative for cancer.

Conclusions

Isolated CL with PD is an alternative radical treatment option for bile duct cancer patients with impaired liver function.

Keywords

Caudate lobectomyPancreatoduodenectomyBile duct cancerPerihilar cholangiocarcinoma

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Tsuyoshi Sano
    • 1
    • 2
  • Yasuhiro Shimizu
    • 1
  • Yoshiki Senda
    • 1
  • Koji Komori
    • 1
  • Seiji Ito
    • 1
  • Tetsuya Abe
    • 1
  • Taira Kinoshita
    • 1
  • Yuji Nimura
    • 1
  1. 1.Hepatobiliary and Pancreatic Surgery Division, Department of Gastroenterological SurgeryAichi Cancer Center HospitalNagoyaJapan
  2. 2.Department of Gastroenterological SurgeryAichi Cancer Center HospitalNagoyaJapan