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Sucher, R; Scheuermann, U; Seehofer, D.
Total Laparoscopic Resection of Hilar Cholangiocarcinoma Type 3b: Applying a Parachute Technique for Hepaticojejunostomy.
Ann Surg Oncol. 2021; 28(4):2030-2034 Doi: 10.1245/s10434-020-09175-1 (- Case Report) [OPEN ACCESS]
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Leading authors Med Uni Graz: Sucher Robert
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Abstract:: BACKGROUND: Laparoscopic liver resection for perihilar cholangiocarcinoma (pCCA) is still in its infancy. The biliary-enteric reconstruction represents one of the most delicate parts of this minimally invasive procedure. METHODS: In this study, a 78-year old woman with perihilar cholangiocarcinoma (pCCA) type 3b underwent a hepaticojejunostomy performed by a parachute technique. RESULTS: The operation, performed totally by minimally invasive resections, was completed in 386 min, with a blood loss of less than 400 ml and no transfusion requirements. Two intraluminal stents were placed during the hepaticojenunostomy for splinting of the biliary-enteric anastomosis. The patient required prolonged antibiotic treatment for postoperative cholangitis and finally was discharged on postoperative day 15. The histopathologic grading displayed a G 2-3 adenocarcinoma, pT3 pN0, M0, L1, V1, pN1, UICC IIIc R0, and the patient was referred to adjuvant chemotherapy. CONCLUSION: Resections of pCCAs, performed totally by minimally invasive techniques, may be feasible and safe for a selected group of patients. With this approach, a running-suture hepaticojejunostomy using the parachute technique represents a worthwhile strategy for biliary-enteric reconstruction.
Find related publications in this database (using NLM MeSH Indexing): Aged - administration & dosage; Anastomosis, Surgical - administration & dosage; Bile Duct Neoplasms - surgery; Bile Ducts, Intrahepatic - surgery; Cholangiocarcinoma - surgery; Female - administration & dosage; Hepatectomy - administration & dosage; Humans - administration & dosage; Klatskin Tumor - surgery; Laparoscopy - administration & dosage; Liver - surgery