World J Gastroenterol. 2013 April 21; 19(15): 2441-2444.
Published online 2013 April 21. doi: 10.3748/wjg.v19.i15.2441.
Duct-to-duct biliary reconstruction after radical resection of Bismuth IIIa hilar cholangiocarcinoma
Wen-Guang Wu, Jun Gu, Ping Dong, Jian-Hua Lu, Mao-Lan Li, Xiang-Song Wu, Jia-Hua Yang, Lin Zhang, Qi-Chen Ding, Hao Weng, Qian Ding and Ying-Bin Liu.
Wen-Guang Wu, Jun Gu, Ping Dong, Jian-Hua Lu, Mao-Lan Li, Xiang-Song Wu, Jia-Hua Yang, Lin Zhang, Qi-Chen Ding, Hao Weng, Qian Ding, Ying-Bin Liu, Depatment of General Surgery, Xinhua Hospital, Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
Author contributions: Wu WG, Gu J and Liu YB designed the research; Dong P, Lu JH, Li ML, Wu XS and Yang JH performed the research; Zhang L, Ding QC, Weng H and Ding Q contributed new reagents or analytic tools; Dong P, Lu JH, Li ML, Wu XS and Yang JH analyzed data; Wu WG, Gu J and Liu YB wrote the paper; Wu WG and Gu J contributed equally to this work.
Correspondence to: Ying-Bin Liu, PhD, MD, Department of General Surgery, Xinhua Hospital, Affiliated to School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai 200092, China. liuybphd@126.com
Telephone: +86-21-25077880 Fax: +86-21-25077880
Received January 25, 2013; Revised March 1, 2013; Accepted March 15, 2013;
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.
Keywords: Hilar cholangiocarcinoma, Biliary reconstruction, Duct-to-duct, Radical resection, Digestive tract reconstruction, Hepaticojejunostomy, Bile duct anastomosis