Radical surgery for right-sided klatskin tumor

Abstract

Local excision of hilar cholangiocarcinomas results in long-term survival in only very few cases. Therefore, the combination of right or left liver resection and bile duct resection has been the standard treatment since about 1990. Five-year survival rates after curative resection could be improved to 30-40%. Recurrence is frequently seen locally, therefore more extended resection with adherence to the surgical principals of tumor resection, such as the "no-touch technique", appears useful. Excellent results with 5-year survival rates up to 60% after curative resection can be achieved with right trisectionectomy together with principle en bloc hilar resection. Perioperative mortality is still high because of the small remaining liver volume.

Figure 1.

Schematic image of the hepatic hilum. The confluence of the right and left hepatic bile ducts is located on the right side of the hepatoduodenal ligament. The right hepatic artery runs on the dorsal side close to the common bile duct. The area of the hepatic hilum that can be approached without dissecting hepatic parenchyma is encircled by the continuous line .