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World J Gastroenterol. Nov 7, 2014; 20(41): 15153-15157
Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15153
Laparoscopy in the management of hilar cholangiocarcinoma
Akihiro Cho, Hiroshi Yamamoto, Osamu Kainuma, Yorihiko Muto, Hiroo Yanagibashi, Toru Tonooka, Takahito Masuda
Akihiro Cho, Hiroshi Yamamoto, Osamu Kainuma, Yorihiko Muto, Hiroo Yanagibashi, Toru Tonooka, Takahito Masuda, Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, Chiba 260-8717, Japan
Author contributions: Cho A, Yamamoto H, Muto Y, Yanagibashi H, Tonooka T and Masuda T searched papers; Cho A and Kainuma O analyzed the data; Cho A wrote the paper.
Correspondence to: Akihiro Cho, MD, Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitonacho, Chuo-ku, Chiba 260-8717, Japan. acho@chiba-cc.jp
Telephone: +81-43-2645431 Fax: +81-43-2628680
Received: October 28, 2013
Revised: January 10, 2014
Accepted: June 20, 2014
Published online: November 7, 2014
Abstract

The use of minimally invasive surgery has become widely accepted in many gastrointestinal fields, even in patients with malignancy. However, performing laparoscopic resection for the treatment of hilar cholangiocarcinoma is still not universally accepted as an alternative approach to open surgery, and only a limited number of such procedures have been reported due to the difficulty of performing oncologic resection and the lack of consensus regarding the adequacy of this approach. Laparoscopy was initially limited to staging, biopsy and palliation. Recent technological developments and improvements in endoscopic procedures have greatly expanded the applications of laparoscopic liver resection and lymphadenectomy, and some reports have described the use of laparoscopic or robot-assisted laparoscopic resection for hilar cholangiocarcinoma as being feasible and safe in highly selected cases, with the ability to obtain an adequate surgical margin. However, the benefits of major laparoscopic surgery have yet to be conclusively proven, and carefully selecting patients is essential for successfully performing this procedure.

Keywords: Hilar cholangiocarcinoma, Laparoscopy, Minimally invasive surgery

Core tip: Recent technological developments and improvements in endoscopic procedures have greatly expanded the applications of laparoscopic liver resection and lymphadenectomy, and some reports have described the use of laparoscopic or robot-assisted laparoscopic resection for hilar cholangiocarcinoma as being feasible and safe in highly selected cases, with the ability to obtain an adequate surgical margin. However, the benefits of major laparoscopic surgery have yet to be conclusively proven, and carefully selecting patients is essential for successfully performing this procedure.