title: Duct-to-duct biliary reconstruction after radical resection of Bismuth IIIa hilar cholangiocarcinoma.
abstract: At present, radical resection remains the only effective treatment for patients with hilar cholangiocarcinoma. The surgical approach for R0 resection of hilar cholangiocarcinoma is complex and diverse, but for the biliary reconstruction after resection, almost all surgeons use Roux-en-Y hepaticojejunostomy. A viable alternative to Roux-en-Y reconstruction after radical resection of hilar cholangiocarcinoma has not yet been proposed. We report a case of performing duct-to-duct biliary reconstruction after radical resection of Bismuth IIIa hilar cholangiocarcinoma. End-to-end anastomosis between the left hepatic duct and the distal common bile duct was used for the biliary reconstruction, and a single-layer continuous suture was performed along the bile duct using 5-0 prolene. The patient was discharged favorably without biliary fistula 2 wk later. Evidence for tumor recurrence was not found after an 18 mo follow-up. Performing bile duct end-to-end anastomosis in hilar cholangiocarcinoma can simplify the complex digestive tract reconstruction process.
authors.affiliation: Depatment of General Surgery, Xinhua Hospital, Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China.
authors.forename: Wen-Guang
authors.initials: WG
authors.lastname: Wu
authors.forename: Jun
authors.initials: J
authors.lastname: Gu
authors.forename: Ping
authors.initials: P
authors.lastname: Dong
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Lu
authors.forename: Mao-Lan
authors.initials: ML
authors.lastname: Li
authors.forename: Xiang-Song
authors.initials: XS
authors.lastname: Wu
authors.forename: Jia-Hua
authors.initials: JH
authors.lastname: Yang
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.forename: Qi-Chen
authors.initials: QC
authors.lastname: Ding
authors.forename: Hao
authors.initials: H
authors.lastname: Weng
authors.forename: Qian
authors.initials: Q
authors.lastname: Ding
authors.forename: Ying-Bin
authors.initials: YB
authors.lastname: Liu
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000379:methods; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012008:Recurrence; D013997:Time Factors
keywords: Bile duct anastomosis; Biliary reconstruction; Digestive tract reconstruction; Duct-to-duct; Hepaticojejunostomy; Hilar cholangiocarcinoma; Radical resection