Clinical application value of total laparoscopic radical resection of Ⅳ-type hilar choangiocarcinoma:video attached
10.3877/cma.j.issn.2095-3232.2018.02.007
- VernacularTitle:全腹腔镜Ⅳ型肝门部胆管癌根治术的临床应用价值(附视频)
- Author:
Xinming YIN
1
;
Yaling LIU
;
Wei CHENG
;
Yifei WU
;
Yi LIU
;
Siwei ZHU
;
Chunhong LIAO
Author Information
1. 湖南省人民医院肝胆外科
- Keywords:
Laparoscopy;
Hepatectomy;
Bile duct neoplasms;
Bilioenterostomy,hepatic
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2018;7(2):110-114
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility and clinical application value of total laparoscopic radical resection of Ⅳ-type hilar choangiocarcinoma. Methods Clinical data of 2 patients receiving total laparoscopic radical resection of Ⅳ-type hilar choangiocarcinoma in Hunan Provincial People's Hospital from April 2015 to December 2015 were analyzed retrospectively. The informed consents of both patients were obtained and the local ethical committee approval was received. Case 1, male, 73 years old, hospitalized for icteric skin and sclera for more than 1 month. Case 2, female, 62 years old, hospitalized for icteric skin and sclera for more than 2 months. The admitting diagnosis were both Ⅳ-type hilar choangiocarcinoma. The bilateral hepatic ducts and left portal vein were invaded by tumor in the 2 cases. Before the operation, the patients received symptomatic and supportive treatments for liver protection, jaundice alleviation etc., and then received total laparoscopic radical resection of hilar choangiocarcinoma. The lymph nodes were resected from far to near, the common bile duct was dissected and cut off, the left and caudate lobe was resected, hilar bile duct plasty and Roux-en-Y bilioenterostomy were performed. Results Operations were performed successfully in both patients and the digestive tract was reconstructed. The operative duration were 430, 410 min respectively, the intraoperative blood loss was 800, 600 ml respectively. No perioperative complication was observed.Two patients received abdominal enhanced CT examination 1 year after operation, no tumor recurrence or metastasis was observed. Conclusion Total laparoscopic radical resection of hilar choangiocarcinoma is safe and feasible, in which hemihepatectomy or extended hemihepatectomy including caudate lobe, lymphadenectomy, bile duct plasty and biliary-enteric reconstruction can be performed.
