Novel en-bloc resection of locally advanced hilar chulangiucarcinuma: the Rex recess approach

Abstract 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...

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Published inHepatobiliary & pancreatic diseases international Vol. 13; no. 1; pp. 93 - 97
Main Authors Rela, Mohamed, Rajalingam, Rajesh, Shanmugam, Vivekanandan, O’Sullivan, Adrian, Reddy, Mettu S, Heaton, Nigel
Format Journal Article
LanguageEnglish
Published Elsevier B.V 15.02.2014
Subjects
cholangiocarcinoma
Endocrinology & Metabolism
Gastroenterology and Hepatology
no-touch technique
Rex recess
vascular resection
vascular resection
Rex recess
no-touch technique
cholangiocarcinoma
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Summary:Abstract 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.
ISSN:1499-3872
DOI:10.1016/S1499-3872(14)60013-8