title: Resection of Perihilar Cholangiocarcinoma.
abstract: Perihilar cholangiocarcinoma presents at the biliary and vascular junction of the hepatic hilum with a tendency to extend longitudinally into segmental bile ducts. Most patients show metastatic or unresectable disease at time of presentation or surgical exploration. In patients eligible for surgical resection, challenges are to achieve negative bile duct margins, adequate liver remnant function, and adequate portal and arterial inflow to the liver remnant. Surgical treatment is characterized by high rates of postoperative morbidity and mortality. This article reviews the various strategies and techniques, the role of staging laparoscopy, intraoperative frozen section, caudate lobectomy, and vascular reconstruction.
authors.affiliation: Division of HPB and Transplant Surgery, Department of Surgery, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: Hermien
authors.initials: H
authors.lastname: Hartog
authors.affiliation: Division of HPB and Transplant Surgery, Department of Surgery, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: Jan N M
authors.initials: JN
authors.lastname: Ijzermans
authors.affiliation: Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: van Gulik
authors.affiliation: Division of HPB and Transplant Surgery, Department of Surgery, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: b.grootkoerkamp@erasmusmc.nl.
authors.forename: Bas
authors.initials: B
authors.lastname: Groot Koerkamp
mesh_terms: D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D000066491:Clinical Decision-Making; D003663:Decision Trees; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007432:Intraoperative Period; D009367:Neoplasm Staging; D011300:Preoperative Care
keywords: Caudate lobectomy; Hepatectomy; Perihilar cholangiocarcinoma; Staging laparoscopy; Vascular reconstruction