BACKGROUND: Pure laparoscopic hemihepatectomy is still a challenging procedure. However, it is a minimally invasive liver surgery that leads to rapid recovery. Intrahepatic cholangiocarcinoma has a poor prognosis, especially when it occurs with lymph node metastasis. We recently had a patient who underwent a pure laparoscopic right hepatectomy and lymph nodes dissection for a large intrahepatic cholangiocarcinoma in the right liver by an anterior approach with hanging maneuver. METHODS: Because the tumor was 77 × 50 mm in diameter, mobilization was performed after the devascularization of the right liver. After the division of the right hepatic artery and the right portal vein, short hepatic veins were sealed and divided with a bipolar vessel sealer from the anterior face of the vena cava, followed by the placement of a tape between the liver and the vena cava for hanging. By means of the hanging maneuver, parenchymal transection was performed with minimal blood loss, and the cut surface of the liver became plane. RESULTS: The operation time was 357 min, and the blood loss was 66 ml. A right hepatectomy and complete lymph node dissection adjacent to the hepatoduodenal ligament were performed successfully with a purely laparoscopic procedure. The postoperative hospital stay was 10 days. The final diagnosis of the intrahepatic cholangiocarcinoma with distant lymph node metastasis in the hepatoduodenal ligament was pT1N1M0 stage IIIb (International Union Against Cancer criteria). CONCLUSIONS: The laparoscopic procedure enabled the patient to have an early discharge and adjuvant chemotherapy of gemcitabine with S1 initiated immediately after discharge. We present a video of the described procedure.
BACKGROUND: Pure laparoscopic hemihepatectomy is still a challenging procedure. However, it is a minimally invasive liver surgery that leads to rapid recovery. Intrahepatic cholangiocarcinoma has a poor prognosis, especially when it occurs with lymph node metastasis. We recently had a patient who underwent a pure laparoscopic right hepatectomy and lymph nodes dissection for a large intrahepatic cholangiocarcinoma in the right liver by an anterior approach with hanging maneuver. METHODS: Because the tumor was 77 × 50 mm in diameter, mobilization was performed after the devascularization of the right liver. After the division of the right hepatic artery and the right portal vein, short hepatic veins were sealed and divided with a bipolar vessel sealer from the anterior face of the vena cava, followed by the placement of a tape between the liver and the vena cava for hanging. By means of the hanging maneuver, parenchymal transection was performed with minimal blood loss, and the cut surface of the liver became plane. RESULTS: The operation time was 357 min, and the blood loss was 66 ml. A right hepatectomy and complete lymph node dissection adjacent to the hepatoduodenal ligament were performed successfully with a purely laparoscopic procedure. The postoperative hospital stay was 10 days. The final diagnosis of the intrahepatic cholangiocarcinoma with distant lymph node metastasis in the hepatoduodenal ligament was pT1N1M0 stage IIIb (International Union Against Cancer criteria). CONCLUSIONS: The laparoscopic procedure enabled the patient to have an early discharge and adjuvant chemotherapy of gemcitabine with S1 initiated immediately after discharge. We present a video of the described procedure.
Authors: K Inoue; M Makuuchi; T Takayama; G Torzilli; J Yamamoto; K Shimada; T Kosuge; S Yamasaki; M Konishi; T Kinoshita; S Miyagawa; S Kawasaki Journal: Surgery Date: 2000-05 Impact factor: 3.982
Authors: D Cherqui; E Husson; R Hammoud; B Malassagne; F Stéphan; S Bensaid; N Rotman; P L Fagniez Journal: Ann Surg Date: 2000-12 Impact factor: 12.969
Authors: Jean-François Gigot; David Glineur; Juan Santiago Azagra; Martine Goergen; Marc Ceuterick; Mario Morino; José Etienne; Jacques Marescaux; Didier Mutter; Ludo van Krunckelsven; Bernard Descottes; Dominique Valleix; François Lachachi; Claude Bertrand; Baudouin Mansvelt; Guy Hubens; Jean-Pierre Saey; Romain Schockmel Journal: Ann Surg Date: 2002-07 Impact factor: 12.969
Authors: Joseph F Buell; Daniel Cherqui; David A Geller; Nicholas O'Rourke; David Iannitti; Ibrahim Dagher; Alan J Koffron; Mark Thomas; Brice Gayet; Ho Seong Han; Go Wakabayashi; Giulio Belli; Hironori Kaneko; Chen-Guo Ker; Olivier Scatton; Alexis Laurent; Eddie K Abdalla; Prosanto Chaudhury; Erik Dutson; Clark Gamblin; Michael D'Angelica; David Nagorney; Giuliano Testa; Daniel Labow; Derrik Manas; Ronnie T Poon; Heidi Nelson; Robert Martin; Bryan Clary; Wright C Pinson; John Martinie; Jean-Nicolas Vauthey; Robert Goldstein; Sasan Roayaie; David Barlet; Joseph Espat; Michael Abecassis; Myrddin Rees; Yuman Fong; Kelly M McMasters; Christoph Broelsch; Ron Busuttil; Jacques Belghiti; Steven Strasberg; Ravi S Chari Journal: Ann Surg Date: 2009-11 Impact factor: 12.969
Authors: Fernando Rotellar; Fernando Pardo; Pablo Martí-Cruchaga; Gabriel Zozaya; Victor Valentí; Manuel Bellver; Luis Lopez-Olaondo; Francisco Hidalgo Journal: Langenbecks Arch Surg Date: 2016-07-12 Impact factor: 3.445