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01-12-2013 | How-I-Do-It article

Isolated caudate lobectomy with pancreatoduodenectomy for a bile duct cancer

Authors: Tsuyoshi Sano, Yasuhiro Shimizu, Yoshiki Senda, Koji Komori, Seiji Ito, Tetsuya Abe, Taira Kinoshita, Yuji Nimura

Published in: Langenbeck's Archives of Surgery | Issue 8/2013

Abstract

Background

In patients with distal bile duct cancer involving the hepatic hilus, a major hepatectomy concomitant with pancreatoduodenectomy (HPD) is sometimes ideal to obtain a cancer-free resection margin. However, the surgical invasiveness of HPD is considerable.

Patients and methods

We present our treatment option for patients with distal bile duct cancer showing mucosal spreading to the hepatic hilum associated with impaired liver function. To minimize resection volume of the liver, an isolated caudate lobectomy (CL) with pancreatoduodenectomy (PD) using an anterior liver splitting approach is presented. Liver transection lines and bile duct resection points correspond complete with our standard right and left hemihepatectomies with CL for perihilar cholangiocarcinoma.

Results

Total operation time was 765 min, and pedicle occlusion time was 124 min, respectively. Although the proximal mucosal cancer extension was identified at both the right and the left hepatic ducts, all resection margins were negative for cancer.

Conclusions

Isolated CL with PD is an alternative radical treatment option for bile duct cancer patients with impaired liver function.

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Title: Isolated caudate lobectomy with pancreatoduodenectomy for a bile duct cancer
Authors: Tsuyoshi Sano
Yasuhiro Shimizu
Yoshiki Senda
Koji Komori
Seiji Ito
Tetsuya Abe
Taira Kinoshita
Yuji Nimura
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 8/2013
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-013-1110-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Isolated caudate lobectomy with pancreatoduodenectomy for a bile duct cancer

Abstract

Background

Patients and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusions

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