Abstract
Left hepatic trisegmentectomy has been performed for huge malignant tumors, but it is rarely applied in patients with hilar cholangiocarcinoma. Twelve consecutive patients (7 men and 5 women; mean age, 64 years) underwent left hepatic trisegmentectomy in our institution between January 2000 and December 2003. The preoperative management and postoperative outcomes of this surgical procedure were presented and retrospectively analyzed. Preoperative biliary drainage and portal vein embolization were performed in 6 patients (50%) and 9 patients (75%), respectively. The preoperative estimated volume ratio of the posterior segment /the whole liver was 44.8 ± 7.0% (34.3–54.3), the plasma retention rate of indocyanine green at 15 minutes was 8.6 ± 2.2% (4.7–13.7), and the serum total bilirubin level before surgery was 1.0 ± 0.4 mg/dl (0.4–1.7). The serum total bilirubin level on the first postoperative day was 3.3 ± 0.4 mg/dl (1.4–6.2). There was no hospital death or postoperative hepatic failure. The incidence of positive resectional margin was 25%. With biliary decompression and preoperative portal embolization techniques, left hepatic trisegmentectomy was a safe and curative resectional option for hilar cholangiocarcinoma.
Similar content being viewed by others
References
CW Pinson RL. Rossi (1998) ArticleTitleExtended right hepatic lobectomy, left hepatic lobectomy, and skeltonization resection for proximal bile duct cancer World J. Surg. 12 52–59 Occurrence Handle10.1007/BF01658486
J Klempnauer GJ Ridder R Wasielewski Particlevon et al. (1997) ArticleTitleResectional surgery of hilar cholangiocarcinoma: a multivariate analysis of prognostic factors J. Clin. Oncol. 15 947–954 Occurrence Handle9060532
EC Burke WR Jarnagin SN Hochwald et al. (1998) ArticleTitleHilar cholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system Ann. Surg. 228 385–394 Occurrence Handle10.1097/00000658-199809000-00011 Occurrence Handle9742921
T Kosuge J Yamamoto K Shimada et al. (1999) ArticleTitleImproved surgical results for hilar cholangiocarcinoma with procedures including major hepatic resection Ann. Surg. 230 663–671 Occurrence Handle10.1097/00000658-199911000-00008 Occurrence Handle10561090
Y Seyama K Kubota K Sano et al. (2003) ArticleTitleLong-term outcome of extended hemihepatectomy for hilar bile duct cancer with no mortality and high survival rate Ann. Surg. 238 73–83 Occurrence Handle10.1097/00000658-200307000-00010 Occurrence Handle12832968
S Kawasaki M Makuuchi S Miyagawa et al. (1994) ArticleTitleRadical operation after portal embolization for tumor of hilar bile duct J. Am. Coll. Surg. 178 480–486 Occurrence Handle7909486
S Miyagawa M Makuuchi S Kawasaki et al. (1996) ArticleTitleOutcome of hepatectomy with pancreatoduodenectomy for advanced biliary malignancies World J. Surg. 20 77–80 Occurrence Handle10.1007/s002689900014 Occurrence Handle8588418
M Nagino J Kamiya K Uesaka et al. (2001) ArticleTitleComplications of hepatectomy for hilar cholangiocarcinoma World J. Surg. 25 1277–1283 Occurrence Handle10.1007/s00268-001-0110-8 Occurrence Handle11596890
TE Starzl S Iwatsuki BW Shaw SuffixJr et al. (1982) ArticleTitleLeft hepatic trisegmentectomy Surg Gynecol. Obstet. 155 21–27
H Hawegawa S Yamasaki M Makuuchi et al. (1989) ArticleTitlePoor prognoses following left hepatic trisegmentectomies for cancer Jpn. J. Clin. Oncol. 19 271–275 Occurrence Handle2554027
JA Rui L Zhou SB Wang et al. (2002) ArticleTitleHepatic trisegmentectomy for 29 patients with huge liver neoplasms Hepatobiliary Pancreat. Dis. Int. 1 187–190 Occurrence Handle14607736
RD Glick EP Nadler LH Blumgart et al. (2000) ArticleTitleExtended left hepatectomy (left hepatic trisegmentectomy) in childhood J. Pediatr. Surg. 35 303–308 Occurrence Handle10.1016/S0022-3468(00)90029-0 Occurrence Handle10693685
M Nagino Y Nimura J Kamiya et al. (1995) ArticleTitleRight or left trisegment portal vein embolization before hepatic trisegmentectomy for hilar bile duct carcinoma Surgery 117 677–681 Occurrence Handle7778031
H Furukawa K Sano T Kosuge et al. (2000) ArticleTitleHilar cholangiocarcinoma evaluated by three-dimensional CT cholangiography and rotating cine cholangiography Hepatogastroenterology 47 615–620 Occurrence Handle10918998
H Bismuth MB. Corlette (1975) ArticleTitleIntrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver Surg. Gynecol. Obstet. 140 170–176 Occurrence Handle1079096
H Bismuth R Nakache T. Diamond (1992) ArticleTitleManagement strategies in resection for hilar cholangiocarcinoma Ann. Surg. 215 31–38 Occurrence Handle1309988
M Makuuchi BL Thai K Takayasu et al. (1990) ArticleTitlePreoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report Surgery 107 521–527 Occurrence Handle2333592
Ijichi M, Makuuchi M, Imamura H, et al. Portal embolization relieves persistent jaundice after complete biliary drainage Surgery 2001;130:116–118
K Kubota M Makuuchi K Kusaka et al. (1997) ArticleTitleManagement of liver volume and hepatic functional reserve as a guide to decision making in resectional surgery for hepatic tumors Hepatology 26 1176–1181 Occurrence Handle9362359
T Takayama M Makuuchi K Kubota et al. (2001) ArticleTitleRandomized comparison of ultrasonic vs clamp transection of the liver Arch. Surg. 136 922–928 Occurrence Handle10.1001/archsurg.136.8.922 Occurrence Handle11485528
Y Ku M Tominaga T Sugimoto et al. (2002) ArticleTitlePreoperative hepatic venous embolization for partial hepatectomy combined with segmental resection of major hepatic vein Br. J. Surg. 89 63–69 Occurrence Handle10.1046/j.0007-1323.2001.01955.x Occurrence Handle11851665
K Inoue M Makuuchi T Takayama et al. (2000) ArticleTitleLong-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma Surgery 127 498–505 Occurrence Handle10819057
Acknowledgments
This study was supported by a Grant-in-Aid for cancer research from the Ministry of Health, Labor, and Welfare of Japan.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shimada, K., Sano, T., Sakamoto, Y. et al. Safety and Effectiveness of Left Hepatic Trisegmentectomy for Hilar Cholangiocarcinoma. World J. Surg. 29, 723–727 (2005). https://doi.org/10.1007/s00268-005-7704-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-005-7704-5