Experience of toatal laparoscopic radical resection of hilar cholangiocarcinoma: a report of 14 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHU Yuxiao , WANG Ji , MA Hongqin , LIU Li ,  ZHAO Wenxing

Department of Oncology Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, P. R. China;

Corresponding?author：

ZHAO Wenxing, Email: wxzhao@sina.com

Keywords：

hilar cholangiocarcinoma; total laparoscopy; radical resection

DOI：

10.7507/1007-9424.201809030

Video：

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Objective To investigate the feasibility, safety and clinical effect of total laparoscopic radical resection of hilar cholangiocarcinoma.Methods Retrospectively summarized the 14 patients with hilar cholangiocarcinoma, who underwent total laparoscopic radical resection of hilar cholangiocarcinoma in the Affiliated Hospital of Xuzhou Medical University from April 2016 to June 2018. Collected the clinical data of those patients, including 7 cases of Bismuth type Ⅰ, 5 cases of Bismuth type Ⅱ, and 2 cases of Bismuth type Ⅲb.Results Total laparoscopic radical resection of hilar cholangiocarcinoma were performed successfully in all 14 patients. The operative time was 190–400 min (median time of 285 min) and the amount of intraoperative blood loss was 100–500 mL (median amount of 175 mL). There was no death case during the perioperative period. Postoperative pathological results showed that all cases accorded with bile duct adenocarcinoma, resection margins of them were negative, amount of lymph node was detected 6–15 per case (median amount of 8 per case), and 3 patients were inspected with peritumoral lymph node metastasis. Two patients were combined with postoperative bile leakage, one of whom was complicated with an abdominal infection, and both were cured and discharged after conservative treatment. All patients were followed-up regularly within 3–24 months (median followed-up period of 16 months). One of them recurred within 12 months after the operation. The remaining patients have survived well so far.Conclusion Under the operation of the experienced surgeon, total laparoscopic radical resection of hilar cholangiocarcinoma is safe, feasible and effective in the short term.

Citation： ZHU Yuxiao, WANG Ji, MA Hongqin, LIU Li, ZHAO Wenxing. Experience of toatal laparoscopic radical resection of hilar cholangiocarcinoma: a report of 14 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(1): 56-60. doi: 10.7507/1007-9424.201809030 Copy

1.	Groot Koerkamp B, Fong Y. Outcomes in biliary malignancy. J Surg Oncol, 2014, 110(5): 585-591.
2.	朱鴻超, 匡天佐, 張福揚, 等. 全腹腔鏡BismuthI型肝門部膽管癌根治術7例. 中國微創外科雜志, 2018, 18(3): 274-276.
3.	張成武, 劉杰. 完全腹腔鏡下Ⅲa型肝門部膽管癌根治\|生切除術. 中國普通外科學雜志, 2017, 32(8): 691-693.
4.	蔡秀軍. 美國癌癥聯合會(AJCC)癌癥分期手冊第8版" 肝門部膽管癌”部分更新解讀. 臨床外科雜志, 2018, 26(1): 10-12.
5.	張輝, 王夢龍. 肝門部膽管癌的可切除性評估. 中華肝膽外科雜志, 2015, 21(11): 789-792.
6.	Cho MS, Kim SH, Park SW, et al. Surgical outcomes and predicting factors of curative resection in patients with hilar cholangiocarcinoma: 10-year single-institution experience. J Gastrointest Surg, 2012, 16(9): 1672-1679.
7.	劉召波, 盧實春. 肝門部膽管癌的外科治療. 中華消化外科雜志, 2013, 12(3): 186-190.
8.	郝志強, 季德剛, 孟子輝, 等. 肝門部膽管癌不同治療方法的療效. 中華肝膽外科雜志, 2017, 23(8): 517-520.
9.	Kang MJ, Jang JY, Chang J, et al. Actual long-term survival outcome of 403 consecutive patients with hilar cholangiocarcinoma. World J Surg, 2016, 40(10): 2451-2459.
10.	劉清華, 汪凌. 87例肝門部位膽管癌手術切除的診療分析. 胃腸病學和肝病學雜志, 2018, 27(7): 804-807.
11.	周寧新, 黃志強, 張文智, 等. 402例肝門部膽管癌臨床分型、手術方式及遠期療效的綜合分析. 中華外科雜志, 2006, 44(23): 1599-1603.
12.	中國醫師協會外科醫師分會膽道外科醫師委員會. 膽道手術加速康復外科專家共識(2016版). 中華消化外科雜志, 2017, 16(1): 6-13.
13.	Park MJ, Kim YK, Lim S, et al. Hilar cholangiocarcinoma: value of adding DW imaging to gadoxetic acid-enhanced MR imaging with MR cholangiopancreatography for preoperative evaluation. Radiology, 2014, 270(3): 768-776.
14.	中國抗癌協會. 肝門部膽管癌規范化診治專家共識(2015). 中華肝膽外科雜志, 2015, 21(8): 505-511.
15.	黃華明, 趙平. 肝門部膽管癌手術切除范圍的研究進展與爭議. 中華肝膽外科雜志, 2018, 24(1): 67-70.
16.	Noji T, Tsuchikawa T, Okamura K, et al. Surgical outcome of hilar plate resection: extended hilar bile duct resection without hepatectomy. J Gastrointest Surg, 2014, 18(6): 1131-1137.
17.	張輝, 王孟龍. 單中心56例肝門部膽管癌的外科治療. 中華肝膽外科雜志, 2017, 23(1): 16-19.
18.	魯敏, 秦興雷, 蔡建平, 等. 89例肝門部膽管癌術后并發癥分析. 中華普通外科學雜志, 2015, 30(7): 535-537.
19.	杜羽升, 趙文星, 王驥, 等. 完全腹腔鏡手術治療肝門部膽管癌(附6例報道). 中國普外基礎與臨床, 2017, 24(12): 1487-1491.

1. Groot Koerkamp B, Fong Y. Outcomes in biliary malignancy. J Surg Oncol, 2014, 110(5): 585-591.
2. 朱鴻超, 匡天佐, 張福揚, 等. 全腹腔鏡BismuthI型肝門部膽管癌根治術7例. 中國微創外科雜志, 2018, 18(3): 274-276.
3. 張成武, 劉杰. 完全腹腔鏡下Ⅲa型肝門部膽管癌根治|生切除術. 中國普通外科學雜志, 2017, 32(8): 691-693.
4. 蔡秀軍. 美國癌癥聯合會(AJCC)癌癥分期手冊第8版" 肝門部膽管癌”部分更新解讀. 臨床外科雜志, 2018, 26(1): 10-12.
5. 張輝, 王夢龍. 肝門部膽管癌的可切除性評估. 中華肝膽外科雜志, 2015, 21(11): 789-792.
6. Cho MS, Kim SH, Park SW, et al. Surgical outcomes and predicting factors of curative resection in patients with hilar cholangiocarcinoma: 10-year single-institution experience. J Gastrointest Surg, 2012, 16(9): 1672-1679.
7. 劉召波, 盧實春. 肝門部膽管癌的外科治療. 中華消化外科雜志, 2013, 12(3): 186-190.
8. 郝志強, 季德剛, 孟子輝, 等. 肝門部膽管癌不同治療方法的療效. 中華肝膽外科雜志, 2017, 23(8): 517-520.
9. Kang MJ, Jang JY, Chang J, et al. Actual long-term survival outcome of 403 consecutive patients with hilar cholangiocarcinoma. World J Surg, 2016, 40(10): 2451-2459.
10. 劉清華, 汪凌. 87例肝門部位膽管癌手術切除的診療分析. 胃腸病學和肝病學雜志, 2018, 27(7): 804-807.
11. 周寧新, 黃志強, 張文智, 等. 402例肝門部膽管癌臨床分型、手術方式及遠期療效的綜合分析. 中華外科雜志, 2006, 44(23): 1599-1603.
12. 中國醫師協會外科醫師分會膽道外科醫師委員會. 膽道手術加速康復外科專家共識(2016版). 中華消化外科雜志, 2017, 16(1): 6-13.
13. Park MJ, Kim YK, Lim S, et al. Hilar cholangiocarcinoma: value of adding DW imaging to gadoxetic acid-enhanced MR imaging with MR cholangiopancreatography for preoperative evaluation. Radiology, 2014, 270(3): 768-776.
14. 中國抗癌協會. 肝門部膽管癌規范化診治專家共識(2015). 中華肝膽外科雜志, 2015, 21(8): 505-511.
15. 黃華明, 趙平. 肝門部膽管癌手術切除范圍的研究進展與爭議. 中華肝膽外科雜志, 2018, 24(1): 67-70.
16. Noji T, Tsuchikawa T, Okamura K, et al. Surgical outcome of hilar plate resection: extended hilar bile duct resection without hepatectomy. J Gastrointest Surg, 2014, 18(6): 1131-1137.
17. 張輝, 王孟龍. 單中心56例肝門部膽管癌的外科治療. 中華肝膽外科雜志, 2017, 23(1): 16-19.
18. 魯敏, 秦興雷, 蔡建平, 等. 89例肝門部膽管癌術后并發癥分析. 中華普通外科學雜志, 2015, 30(7): 535-537.
19. 杜羽升, 趙文星, 王驥, 等. 完全腹腔鏡手術治療肝門部膽管癌(附6例報道). 中國普外基礎與臨床, 2017, 24(12): 1487-1491.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experience of toatal laparoscopic radical resection of hilar cholangiocarcinoma: a report of 14 cases

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