Laparoscopic Management of Hilar Cholangiocarcinoma
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Abstract
The only option for cure of Klatskin’s tumour is surgical excision. The radicality of the procedure is determined by the extent of the tumour and functional parameters of the patient. Complete laparoscopic resection of hilar cholangiocarcinoma with biliary reconstruction is a challenging procedure. The main aim is to achieve pathological negative margins, complete lymph node retrieval and enterobiliary bypass. We present a case report of a patient with hilar cholangiocarcinoma managed laparoscopically. The nodal yield was nine. On 6-month follow-up, the patient was symptom free. The main aim is to study the feasibility of performing this complex procedure completely laparoscopically.

Case
A 25-year-old gentleman presented with nausea, vomiting and anorexia since 2 months, with no palpable mass per-abdominally. He had a clinical and biochemical picture of obstructive jaundice with a direct bilirubin of 20 mg/dl and alkaline phosphatase of 364. His Ca 19-9 values were raised. Triple phase CECT abdomen showed common hepatic duct (CHD) stricture extending proximally up to confluence, collapsed gall bladder and dilated intrahepatic biliary radicals (Fig. 1a). A preoperative per-cutaneous transhepatic biliary drainage (PTBD) was done to correct hyperbilirubinaemia. Biliary brushing cytology was negative for malignancy......

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848218/
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