Anterior approach for right hepatectomy for hilar cholangiocarcinoma.
OBJECTIVE
Right hepatectomy is indicated for hilar cholangiocarcinoma, but mobilization of the right lobe could be difficult when perihepatic adhesion develops in response to repeated cholangitis and forceful mobilization may disseminate bacteria if the obstructed biliary tract contains pus. We encountered a patient who died from postoperative sepsis and multiorgan failure.


METHODS
To circumvent such a difficulty, we employed the anterior approach right hepatectomy in a second patient with hilar cholangiocarcinoma. In this patient, liver transection and division of the hepatic vein were performed before mobilization of the right lobe.


RESULTS
The second patient recovered uneventfully.


CONCLUSIONS
The anterior approach (utilizing the "no-touch" technique) may be a preferred procedure for right hepatectomy for hilar cholangiocarcinoma.
Liu
Chi-Leung
CL
Centre for the Study of Liver Disease and Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, P.R. China.
Fan
Sheung-Tat
ST
D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D016896:Treatment Outcome