Novel en-bloc resection of locally advanced hilar cholangiocarcinoma: the Rex recess approach.
Loco-regional recurrence after potentially curative resection remains a problem in hilar cholangiocarcinoma. Hilar dissection risks local spillage of tumor cells leading to suboptimal disease free survival. We have developed a new technique of radical resection for hilar cholangiocarcinoma based on the distinctive anatomy of the Rex recess of the liver, which has been assessed in two patients with locally advanced hilar cholangiocarcinoma. This technique included a right hepatectomy with en-bloc resection of the hepatoduodenal ligament and portal venous reconstruction to the left portal vein at the Rex recess. Both patients had R0 resection and have been disease-free for 26 and 38 months, respectively.
Institute of Liver Studies, King's College Hospital, London, UK; Institute of Liver Surgery and Transplantation, Global Hospital and Health City, Chennai 600100, India. mohamed.rela@kcl.ac.uk or Mohamed.rela@gmail.com.
Mohamed
M
Rela
Rajesh
R
Rajalingam
Vivekanandan
V
Shanmugam
Adrian
A
O' Sullivan
Mettu S
MS
Reddy
Nigel
N
Heaton
D000328:Adult; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008022:Ligaments / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011169:Portal Vein / Q000601:surgery; D016896:Treatment Outcome