ABSTRACT
Extended liver resection may provide longterm survival in selected patients with hilar cholangiocarcinoma.In May 2013,a patient with hilar cholangiocarcinoma received right hemihepatectomy combined with caudate lobectomy under the guidance of precision hepatectomy technique.The porta hepatis was clamped in the operation for 3 times intermittently.The operation time was 8 hours,and the volume of intraoperative blood loss was 600 mL.The patient was discharged at postoperative day 14.The results of pathological examination confirmed that the patient had moderately-highly differentiated adenocarcinoma with full-thickness infiltration of the bile duct and tumorfree margins.No tumor recurrence was detected during the followup which was lasted for 6 months.The operation was carried out based on the three dimensional reconstruction,liver reserve function evaluation,intraoperative controlled low central venous pressure and precision hepatectomy technique,and the results were satisfactory.
ABSTRACT
Hepatectomy for huge hepatocellular carcinoma (HCC) is difficult due to its huge size and the compression and invasion to the surrounding tissues as well as the important vascular systems.Surgical resection of huge carcinoma in the caudate lobe is a big challenge for hepatobiliary surgeons because of its special location and complex anatomical structure.As the improvement of surgical techniques in recent years,especially the promotion of the concept of precision liver surgery,many surgeons begin to take the challenge of resection of huge HCC in the caudate lobe in a variety of ways.In April 2014,a male patient aged 58 years with huge HCC in the caudate lobe was admitted to the Anhui Provincial Hospital.Precision right hemihepatectomy combined with caudate lobectomy was performed on this patient without occlusion of the hepatic inflow,and the efficacy was satisfactory.The key techniques involved in this procedure were discussed in this article.
ABSTRACT
Tumor in the caudate lobe is difficult for surgical treatment due to its unusual local anatomy.As the development of surgical techniques,the success rate of caudate lobectomy is increased.In recent years,the concept of precision hepatectomy aiming to reduce the iatrogenic damage from hepatectomy and improving the recovery of patients on the basis of radical treatment has been raised.This article summarized the experiences of precision hepatectomy for the treatment of huge tumor in the caudate lobe which was performed in the Ruijin Hospital of Shanghai Jiaotong University.With the help of precision hepatectomy concept and techniques,a more satisfactory result both in safety and prognosis was achieved.