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Six-year survival following left hepatic trisectionectomy with simultaneous resection of the portal vein and right hepatic artery for advanced perihilar cholangiocarcinoma without lymph node metastases: report of a case

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Abstract

We report a case of survival for more than 6 years following left hepatic trisectionectomy and caudate lobectomy with simultaneous resection of the portal vein and right hepatic artery. The patient was a 65-year-old woman admitted to a local hospital with obstructive jaundice. The patient was diagnosed with perihilar cholangiocarcinoma and referred to our hospital. The tumor was located mainly in the left hilar region and occluded the left portal vein; furthermore, it involved the right portal vein and the right hepatic artery. The patient underwent left hepatic trisectionectomy and caudate lobectomy with simultaneous resection of the portal vein and right hepatic artery. The histological findings revealed that the tumor had invaded the portal vein and surrounded the right hepatic artery without any lymph node metastases. Microscopic curative (R0) resection was achieved. The patient is now healthy and still alive 6 years and 6 months after the surgery without any recurrence. Precise preoperative evaluation of the tumor and R0 resection by extended surgery contributed to a satisfactory outcome.

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References

  1. Kondo S, Hirano S, Ambo Y, Tanaka E, Okushiba S, Morikawa T, et al. Forty consecutive resections of hilar cholangiocarcinoma with no postoperative mortality and no positive ductal margins: results of a prospective study. Ann Surg. 2004;240(1):95–101.

    Article  PubMed  Google Scholar 

  2. Ebata T, Nagino M, Kamiya J, Uesaka K, Nagasaka T, Nimura Y. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases. Ann Surg. 2003;238(5):720–7.

    Article  PubMed  Google Scholar 

  3. Miyazaki M, Kato A, Ito H, Kimura F, Shimizu H, Ohtsuka M, et al. Combined vascular resection in operative resection for hilar cholangiocarcinoma: does it work or not? Surgery. 2007;141(5):581–8.

    Article  PubMed  Google Scholar 

  4. Nagino M, Nimura Y, Kamiya J, Kondo S, Kanai M. Selective percutaneous transhepatic embolization of the portal vein in preparation for extensive liver resection: the ipsilateral approach. Radiology. 1996;200(2):559–63.

    PubMed  CAS  Google Scholar 

  5. Sobin LH, Gospodarowicz MK, Wittekind C, International Union against Cancer. TNM classification of malignant tumours. 7th ed. Hoboken: Wiley-Blackwell; 2010.

    Google Scholar 

  6. Gerhards MF, van Gulik TM, de Wit LT, Obertop H, Gouma DJ. Evaluation of morbidity and mortality after resection for hilar cholangiocarcinoma—a single center experience. Surgery. 2000;127(4):395–404.

    Article  PubMed  CAS  Google Scholar 

  7. Yamanaka N, Yasui C, Yamanaka J, Ando T, Kuroda N, Maeda S, et al. Left hemihepatectomy with microsurgical reconstruction of the right-sided hepatic vasculature. A strategy for preserving hepatic function in patients with proximal bile duct cancer. Langenbecks Arch Surg. 2001;386(5):364–8.

    Article  PubMed  CAS  Google Scholar 

  8. Kaneoka Y, Yamaguchi A, Isogai M, Suzuki M. Longer than 3-year survival following hepato-ligamento-pancreatoduodenectomy for hilar cholangiocarcinoma with vascular involvement: report of a case. Surg Today. 2003;33(10):772–6.

    Article  PubMed  Google Scholar 

  9. Shimada H, Endo I, Sugita M, Masunari H, Fujii Y, Tanaka K, et al. Hepatic resection combined with portal vein or hepatic artery reconstruction for advanced carcinoma of the hilar bile duct and gallbladder. World J Surg. 2003;27(10):1137–42.

    Article  PubMed  Google Scholar 

  10. Maeda H, Okabayashi T, Machida T, Shimada K, Kajikawa S, Amano J, et al. Long-term disease-free postoperative survival after combined vascular resection for hilar cholangiocarcinoma. Am Surg. 2011;77(5):E82–4.

    PubMed  Google Scholar 

  11. Nagino M, Nimura Y, Nishio H, Ebata T, Igami T, Matsushita M, et al. Hepatectomy with simultaneous resection of the portal vein and hepatic artery for advanced perihilar cholangiocarcinoma: an audit of 50 consecutive cases. Ann Surg. 2010;252(1):115–23.

    Article  PubMed  Google Scholar 

  12. Fukami Y, Ebata T, Yokoyama Y, Igami T, Sugawara G, Takahashi Y, et al. Diagnostic ability of MDCT to assess right hepatic artery invasion by perihilar cholangiocarcinoma with left-sided predominance. J Hepatobiliary Pancreat Sci. 2011;19:179–86.

    Article  Google Scholar 

  13. Lee SG, Song GW, Hwang S, Ha TY, Moon DB, Jung DH, et al. Surgical treatment of hilar cholangiocarcinoma in the new era: the Asan experience. J Hepatobiliary Pancreat Sci. 2010;17(4):476–89.

    Article  PubMed  Google Scholar 

  14. Unno M, Katayose Y, Rikiyama T, Yoshida H, Yamamoto K, Morikawa T, et al. Major hepatectomy for perihilar cholangiocarcinoma. J Hepatobiliary Pancreat Sci. 2010;17(4):463–9.

    Article  PubMed  Google Scholar 

  15. Igami T, Nishio H, Ebata T, Yokoyama Y, Sugawara G, Nimura Y, et al. Surgical treatment of hilar cholangiocarcinoma in the “new era”: the Nagoya University experience. J Hepatobiliary Pancreat Sci. 2010;17(4):449–54.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Takashi Seki, Tsuyoshi Igami, Tomoki Ebata, Yukihiro Yokoyama, Gen Sugawara, Kiyoshi Suzumura & Masato Nagino

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  1. Takashi Seki
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  2. Tsuyoshi Igami
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  3. Tomoki Ebata
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  4. Yukihiro Yokoyama
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  5. Gen Sugawara
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  6. Kiyoshi Suzumura
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  7. Masato Nagino
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Correspondence to Masato Nagino.

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Seki, T., Igami, T., Ebata, T. et al. Six-year survival following left hepatic trisectionectomy with simultaneous resection of the portal vein and right hepatic artery for advanced perihilar cholangiocarcinoma without lymph node metastases: report of a case. Clin J Gastroenterol 5, 327–331 (2012). https://doi.org/10.1007/s12328-012-0322-5

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  • DOI: https://doi.org/10.1007/s12328-012-0322-5

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