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Laparoscopic resection of hilar cholangiocarcinoma.
Machado, Marcel Autran C; Makdissi, Fabio F; Surjan, Rodrigo C; Mochizuki, Miki.
Afiliação
  • Machado MA; University of São Paulo, São Paulo, Brazil. dr@drmarcel.com.br
J Laparoendosc Adv Surg Tech A ; 22(10): 954-6, 2012 Dec.
Article em En | MEDLINE | ID: mdl-23101791
BACKGROUND: Surgical resection is the only curative treatment for hilar cholangiocarcinoma. Laparoscopic hepatectomy has been used to treat several types of liver neoplasms. However, technical issues have limited the adoption of laparoscopy for the treatment of hilar cholangiocarcinoma. To date there is only one report of minimally invasive procedure for hilar cholangiocarcinoma in the literature. The present video-assisted procedure shows a laparoscopic resection of hilar cholangiocarcinoma. PATIENT AND METHODS: A 43-year-old woman with progressive jaundice due to left-sided hilar cholangiocarcinoma was referred for treatment. The decision was to perform a laparoscopic left hepatectomy with lymphadenectomy and resection of extrahepatic bile ducts. Biliary reconstruction was performed using the hybrid method. RESULTS: Operative time was 300 minutes with minimum blood loss and no need for blood transfusion. Recovery was uneventful, and the patient was discharged on postoperative Day 7. Pathology revealed a well-differentiated cholangiocarcinoma with negative lymph nodes and clear surgical margins. The patient is well with no signs of the disease 18 months after the procedure. CONCLUSIONS: Laparoscopic left hepatectomy with lymphadenectomy is safe and feasible in selected patients and when performed by surgeons with expertise in liver surgery and minimally invasive techniques. The use of a hybrid method may be needed for biliary reconstruction, especially in cases where position and size of remnant bile ducts may jeopardize the anastomosis. Further studies are still needed to confirm the benefit of this approach over conventional surgery for hilar cholangiocarcinoma.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias dos Ductos Biliares / Ductos Biliares Intra-Hepáticos / Laparoscopia / Colangiocarcinoma Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans Idioma: En Revista: J Laparoendosc Adv Surg Tech A Ano de publicação: 2012 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias dos Ductos Biliares / Ductos Biliares Intra-Hepáticos / Laparoscopia / Colangiocarcinoma Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans Idioma: En Revista: J Laparoendosc Adv Surg Tech A Ano de publicação: 2012 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos