The hepatic artery reconstruction first approach in hilar cholangiocarcinoma type IIIb

Abstract

Even though recent advances in liver surgery have led to a more efficient approach to hilar cholangiocarcinoma (HC), resection with curative intent remains a challenge for hepatobiliary surgeons [1]. There is strong evidence to show better survival and long-term outcomes when microscopically tumor-free surgical margins are obtained in these patients [2]. En-bloc resections of liver parenchyma with the extrahepatic bile duct is mandatory to manage tumors with direct hepatic invasion, as well as to accomplish an R0 resection on tumors that frequently extend longitudinally out to involve the hepatic ducts [3-5].