No-touch resection of hilar malignancies with right hepatectomy and routine portal reconstruction
- 10 April 2009
- journal article
- Published by Springer Science and Business Media LLC in Journal of Hepato-Biliary-Pancreatic Surgery
- Vol. 16 (4), 502-507
- https://doi.org/10.1007/s00534-009-0093-7
Abstract
Locoregional recurrence following resection of hilar biliary cancers could be caused by the microscopic dissemination of cancer cells during dissection of the portal vein from the involved bile duct at the hilar region. This retrospective study assessed the feasibility and safety of a new procedure consisting of right-sided hepatectomy, caudate lobectomy, and bile duct resection combined with routine resection of the portal bifurcation to enable no-touch resection of hilar malignancies. Of 64 patients who underwent right-sided hepatectomy for hilar biliary cancer, the portal bifurcation was routinely resected by the above new procedure in 25 patients, based on preoperative imaging diagnoses. Perioperative outcomes were compared with those in patients who underwent conventional portal reconstruction (n = 18) and with those in patients who had preservation of the portal bifurcation (n = 21). Perioperative data from patients with routine portal reconstruction were similar to those in the patients with conventional portal reconstruction and the patients without portal reconstruction. There were no postoperative complications directly related to portal reconstruction. No-touch resection of hilar malignancies with right hepatectomy and the routine use of portal reconstruction was feasible and safe. The oncologic impact of this technique merits further evaluation.Keywords
This publication has 18 references indexed in Scilit:
- Forty Consecutive Resections of Hilar Cholangiocarcinoma With No Postoperative Mortality and No Positive Ductal MarginsAnnals of Surgery, 2004
- Hepatectomy With Portal Vein Resection for Hilar CholangiocarcinomaAnnals of Surgery, 2003
- Portal vein resection and reconstruction prior to hepatic dissection during right hepatectomy and caudate lobectomy for hepatobiliary cancerBritish Journal of Surgery, 2003
- Extensive surgery for carcinoma of the gallbladderBritish Journal of Surgery, 2002
- Evaluation of morbidity and mortality after resection for hilar cholangiocarcinoma—a single center experienceSurgery, 2000
- Aggressive preoperative management and extended surgery for hilar cholangiocarcinoma: Nagoya experienceJournal of Hepato-Biliary-Pancreatic Surgery, 2000
- One hundred and eleven liver resections for hilar bile duct cancerJournal of Hepato-Biliary-Pancreatic Surgery, 2000
- Clinical significance of portal invasion by pancreatic head carcinomaSurgery, 1995
- Combined portal vein and liver resection for carcinoma of the biliary tractBritish Journal of Surgery, 1991
- Clinicopathological Aspects of High Bile Duct CancerAnnals of Surgery, 1984