Case Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2014; 20(45): 17260-17264
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.17260
Resection of a cholangiocarcinoma via laparoscopic hepatopancreato- duodenectomy: A case report
Miao-Zun Zhang, Xiao-Wu Xu, Yi-Ping Mou, Jia-Fei Yan, Yi-Ping Zhu, Ren-Chao Zhang, Yu-Cheng Zhou, Ke Chen, Wei-Wei Jin, Erik Matro, Harsha Ajoodhea
Miao-Zun Zhang, Xiao-Wu Xu, Yi-Ping Mou, Jia-Fei Yan, Yi-Ping Zhu, Ren-Chao Zhang, Yu-Cheng Zhou, Ke Chen, Wei-Wei Jin, Erik Matro, Harsha Ajoodhea, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Author contributions: Zhang MZ, Xu XW, Mou YP and Zhou YC performed the operation; Yan JF, Zhu YP, Chen K and Jin WW collected case data; Zhang MZ, Matro E and Ajoodhea H wrote the manuscript; Mou YP proofread and revised the manuscript; all authors approved the version to be published.
Supported by Zhejiang Key Subject of Medical Science Foundation, grant No. 11-CX-21; and The Health and Family Planning Commission of Zhejiang Province, No. 2012KYB113
Correspondence to: Yi-Ping Mou, MD, FACS, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. mouyp@srrsh.com
Telephone: +86-571-86006952 Fax: +86-571-86044817
Received: June 15, 2014
Revised: July 31, 2014
Accepted: September 12, 2014
Published online: December 7, 2014
Processing time: 177 Days and 16.4 Hours
Abstract

Some laterally advanced cholangiocarcinomas behave as ductal spread or local invasion, and hepatopancreatoduodenectomy (HPD) may be performed for R0 resection. To date, there have been no reports of laparoscopic HPD (LHPD) in the English literature. We report the first case of LHPD for the resection of a Bismuth IIIa cholangiocarcinoma invading the duodenum. The patient underwent laparoscopic pancreaticoduodenectomy and right hemihepatectomy. Child’s approach was used for the reconstruction. The patient recovered well with bile leakage from the 2nd postoperative day and was discharged on the 16th postoperative day with a drainage tube in place which was removed 2 wk after discharge. Postoperative pathology revealed a well-differentiated cholangiocarcinoma and the margin of liver parenchyma, pancreas and stomach was negative for metastases. The results suggest that LHPD is a feasible and safe procedure when performed in highly specialized centers and in suitable patients with cholangiocarcinoma.

Keywords: Laparoscopic surgery; Hemihepatectomy; Pancreaticoduodenectomy; Hepatopancreatoduodenectomy; Cholangiocarcinoma

Core tip: This is the first report of laparoscopic hepatopancreatoduodenectomy (LHPD) for cholangiocarcinoma in the English literature. The patient was treated with laparoscopic pancreaticoduodenectomy and right hemihepatectomy. The successful outcome suggests that LHPD is a feasible and safe procedure when performed in highly specialized centers and in suitable patients with cholangiocarcinoma.