首页|First Affiliated Hospital of Chongqing Medical University Reports Findings in Hi lar Cholangiocarcinoma (Robotic Right Hepatectomy with En Bloc Caudatectomy for Bismuth IIIa Hilar Cholangiocarcinoma: A Video Demonstration of Left-Liver-First ...)
First Affiliated Hospital of Chongqing Medical University Reports Findings in Hi lar Cholangiocarcinoma (Robotic Right Hepatectomy with En Bloc Caudatectomy for Bismuth IIIa Hilar Cholangiocarcinoma: A Video Demonstration of Left-Liver-First ...)
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esearch on Oncology - Hilar Chola ngiocarcinoma is the subject of a report. According to news reporting out of Cho ngqing, People's Republic of China, by NewsRx editors, research stated, "Minimal ly invasive resection for perihilar cholangiocarcinoma is a complicated and tech nically demanding surgical procedure. Radical surgical resection is regarded as the best treatment for hepatic hilar cholangiocarcinoma." Our news journalists obtained a quote from the research from the First Affiliate d Hospital of Chongqing Medical University, "Right hepatectomy with caudate lobe resection is necessary as the treatment for bismuth IIIa hilar cholangiocarcino ma. The left-liver-first anterior radical modular orthotopic right hemihepatecto my (LARMORH), which can simplify surgical steps and decrease procedural difficul ty, may be a better choice for Bismuth IIIa hilar cholangiocarcinoma. However, t here are no reports of this approach using robotic technique for this operation. We will provide a detailed introduction to this method through this video. A 45 -year-old female patient was diagnosed with a hilar cholangiocarcinoma. Followin g a 7-day percutaneous biliary drainage of the left intrahepatic bile duct and o btaining informed consent, we performed a robotic radical resection of the HCCA using the LARMORH approach. The patient was positioned supine with the entire be d elevated 20° and tilted 15° to the left. Trocars were placed in position (Fig. 1). After entering the abdominal cavity, it was explored for tumor metastasis. The surgery adopted a left approach, initially exploring the left hepatic artery and vein to further assess resectability. After confirming resectability, the r ight hepatic artery and gastroduodenal artery (GDA) were dissected. The common b ile duct was dissected and transected at its distal end, ensuring R0 surgical ma rgins. Lymph nodes were cleared from the foot side to the head side, confirming the metastasis to the lymph node group 13a, so we further cleared the group 16 a nd 9 lymph nodes. Subsequently, we approached the resection of the right half an d the entire caudate lobe with the reverse thinking of left hepatic resection mo de, preserving only the left branch of the portal vein and left hepatic artery, and dissecting the liver tissue along the resection plane of the left liver. Aft er transection of the left hepatic duct, the activity space of the left liver wa s larger and the caudate lobe could be better exposed. The Spiegel lobe was lift ed to the right in a ‘turn the page' fashion for in situ resection of the entire caudate lobe and the right half of the liver. Finally, a bilioenteric anastomos is was performed using the Roux-en-Y method. Robotic right hepatectomy with caud ate lobectomy was successfully performed in 450 min, with an estimated blood los s of 200 ml. The histological grading was determined as T1aN1M0 (stage IIIB) on the basis of postoperative pathological biopsy results. The patient achieved a s atisfactory postoperative recovery and was discharged on the 14th postoperative day without any major complications. Following the operation, the patient receiv ed capecitabine chemotherapy according to the Chinese Society of Clinical Oncolo gy (CSCO) criteria. Since September 2022, our team has completed three radical r esections for Bismuth IIIa HCCA using this technique. All patients achieved a sa tisfactory postoperative recovery without any further complications. Robotic lef t-liver-first anterior radical modular orthotopic right hemihepatectomy for Bism uth IIIa HCCA is both safe and feasible."
ChongqingPeople's Republic of ChinaA siaAngiologyCancerDigestive System Surgical ProceduresEmerging Technolog iesHealth and MedicineHemihepatectomyHepatectomyHepatic ArteryHilar Ch olangiocarcinomaMachine LearningOncologyRoboticsRobotsSurgery
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