Liver Transection-First Approach in Left Trisectionectomy for Perihilar Cholangiocarcinoma.

Annals of Surgical Oncology
Isamu HosokawaMasaru Miyazaki

Abstract

Left trisectionectomy [(LT) resection of segments 2, 3, 4, 5, 8, and 1] for perihilar cholangiocarcinoma is still a challenging procedure with high postoperative morbidity and mortality. To perform LT safely, the liver transection-first approach was developed. In this approach, liver transection is started without dividing the right anterior hepatic artery (RAHA) and right anterior portal vein (RAPV). After the completion of liver transection, the RAHA and RAPV, which run into the future resected liver, can be easily identified and divided under the wide surgical field at the hepatic hilus. The liver transection-first approach appears to be safer than the conventional LT, leading to less postoperative morbidity and mortality.

References

Nov 26, 2009·Journal of Hepato-biliary-pancreatic Sciences·Masaru MiyazakiShigetugu Takano
Apr 1, 2011·World Journal of Surgery·Yuichiro YoshiokaMasato Nagino
Mar 20, 2015·Journal of Hepato-biliary-pancreatic Sciences·Masaru MiyazakiTadahiro Takada
Nov 30, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Naohisa KuriyamaHiroyuki Sakurai
Mar 5, 2017·Journal of Hepato-biliary-pancreatic Sciences·Takehito OtsuboMasakazu Yamamoto
Oct 7, 2018·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Isamu HosokawaMasayuki Ohtsuka
Dec 1, 2018·Surgical and Radiologic Anatomy : SRA·Isamu HosokawaHiroaki Shimizu

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