title: Laparoscopic resection of Bismuth type I and II hilar cholangiocarcinoma: an audit of 14 cases from two institutions.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of laparoscopic resection of Bismuth type I and II hilar cholangiocarcinoma.
  
  
  BACKGROUND
  Laparoscopic resection of hilar cholangiocarcinoma is uncommon.
  
  
  METHODS
  Fourteen cases of Bismuth type I and II hilar cholangiocarcinoma were selected for laparoscopic resection. Eight cases involved local resection and 6 cases included partial hepatectomy.
  
  
  RESULTS
  The mean operating time and blood loss were 305 min and 386 ml, respectively. The R0 resection rate was 100 and 60% in patients with type I and II lesions, respectively. The mean postoperative hospital stay was 9 days and 19 days in patients with type I and II tumor, respectively. In-hospital mortality and morbidity were 0 and 35.7% (5 of 14 patients), respectively. Bile leakage occurred in 1 of 7 (14.3%) and 3 of 5 (60%) patients with type I and II tumors, respectively. Port-site metastases were found in 2 cases of type II tumor. The survival rate during a 20-month follow-up period was 85.7% (12 of 14 patients).
  
  
  CONCLUSIONS
  Laparoscopic resection is a potential alternative to open surgery for appropriately selected patients with Bismuth type I hilar cholangiocarcinoma. Due to the lower R0 resection and more complications, the value of laparoscopic resection for patients with type II tumors needs further evaluation.
authors.affiliation: First Minimally Invasive and Biliary Tract Surgery Unit, Shengjing Hospital, China Medical University, Shenyang, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.forename: Shuo-dong
authors.initials: SD
authors.lastname: Wu
authors.forename: De-xing
authors.initials: DX
authors.lastname: Chen
authors.forename: Gang
authors.initials: G
authors.lastname: Zhu
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D001810:Blood Volume; D018281:Cholangiocarcinoma / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D017052:Hospital Mortality; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors