Cholangiocellular carcinoma--the role of caudate lobe resection and mesohepatectomy.
BACKGROUND
The surgical treatment of perihilar cholangiocellular carcinoma (CCC) is challenging due to the adjacency of the tumor to the hilar vessels, major hepatic veins, bile ducts, and the inferior vena cava. Additionally, the tumour frequently infiltrates the parenchyma of the caudate lobe or/and invades its bile ducts.


METHODS
Negative margin caudate hepatectomy is rarely feasible. Isolated partial or complete caudate lobe resection is an oncologically inadequate procedure. Extended hepatectomies in combination with caudate lobectomy can provide prolonged survival, even in patients with advanced CCC. Mesohepatectomy is an oncologically adequate procedure for selected patients with CCC and compromised liver function. The procedure is technically demanding; however, it lowers the risk of postoperative liver failure.
Malago
Massimo
M
Department of General, Viceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. m.malago@ucl.ac.uk
Frilling
Andrea
A
Li
Jun
J
Lang
Hauke
H
Broelsch
Christoph E
CE
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