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[Members Only] J.Jpn. Surg. Soc.. 115(4): 181-184, 2014
Feature topic
REVIEW OF SURGICAL TREATMENT OF PERIHILAR CHOLANGIOCARCINOMA: PROPER PATIENT SELECTION FOR COMBINED VASCULAR RESECTION AND RECONSTRUCTION
Surgical outcomes in patients with hilar cholangiocarcinoma have improved markedly in recent years based on advances in diagnostic imaging, preoperative management, surgical skill, and postoperative management. The selection of the operative procedure is determined based on the localization of the tumor and the remaining function of the future remnant liver, calculated by the future remnant volume and plasma indocyanine green disappearance rate. If there is infiltration into the contralateral artery and/or portal vein or both the left and right branch, combined resection of the artery and/or portal vein is selected. Combined resection and reconstruction of the portal vein have been established in high-volume centers in Japan. Recently, good outcomes of combined arterial resection and reconstruction have been reported, although it is still not the standard treatment in terms of outcomes and complications. Proper patient selection for combined vascular resection and reconstruction must be established in the future.
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