title: Successful Parenchyma-Sparing Anatomical Surgery by 3-Dimensional Reconstruction of Hilar Cholangiocarcinoma Combined with Anatomic Variation.
abstract: The combination of hilar cholangiocarcinoma and anatomic variation constitutes a rare and complicated condition. Precise understanding of 3-dimensional position of tumor in the intrahepatic structure in such cases is important for operation planning and navigation. We report a case of a 61-year woman presenting with hilar cholangiocarcinoma. Anatomic variation and tumor location were well depicted on preoperative multidetector computed tomography (MDCT) combined with 3-dimensional reconstruction as the right posterior segmental duct drained to left hepatic duct. The common hepatic duct, biliary confluence, right anterior segmental duct, and right anterior branch of portal vein were involved by the tumor (Bismuth IIIa). After carefully operation planning, we successfully performed a radical parenchyma-sparing anatomical surgery of hilar cholangiocarcinoma: Liver segmentectomy (segments 5 and 8) and caudate lobectomy. MDCTcombined with 3-dimensional reconstruction is a reliable non-invasive modality for preoperative evaluation of hilar cholangiocarcinoma.
authors.affiliation: Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Qihong
authors.initials: Q
authors.lastname: Ni
authors.affiliation: Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Haolu
authors.initials: H
authors.lastname: Wang
authors.affiliation: Therapeutics Research Centre, School of Medicine, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Australia.
authors.forename: Xiaowen
authors.initials: X
authors.lastname: Liang
authors.affiliation: Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Yunhe
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D002758:Cholangiography / Q000379:methods*; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016896:Treatment Outcome