Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2663-2673
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2663
Systematic sequential therapy for ex vivo liver resection and autotransplantation: A case report and review of literature
Chen-Lu Hu, Xin Han, Zhen-Zhen Gao, Bo Zhou, Jin-Long Tang, Xiang-Ru Pei, Jie-Nan Lu, Qin Xu, Xiao-Ping Shen, Sheng Yan, Yuan Ding
Chen-Lu Hu, Xiang-Ru Pei, Jie-Nan Lu, Qin Xu, Xiao-Ping Shen, Department of Nursing, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Xin Han, Zhen-Zhen Gao, Bo Zhou, Sheng Yan, Yuan Ding, Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Jin-Long Tang, Department of Pathology, Zhejiang University School of Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Co-first authors: Chen-Lu Hu and Xin Han.
Co-corresponding authors: Sheng Yan and Yuan Ding.
Author contributions: Yan S and Ding Y conceived of, designed and refined the study protocol; Hu CL, Han X, Gao ZZ, Zhou B, Tang JL, Fei XR, Lu JN, Xu Q, and Shen XP were involved in the data collection and analysis; Hu CL and Han X drafted the manuscript; all authors were involved in the critical review of the results and contributed to, read, and approved the final manuscript. Hu CL and Han X equally contributed to this work as co-first authors; Yan S and Ding Y contributed equally to this work as co-corresponding authors. There are two reasons for this designation. First, the research was performed as a collaborative effort, and the designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resulting paper. This also ensures effective communication and management of postsubmission matters, ultimately enhancing the paper's quality and reliability. Second, Hu CL and Han X contributed equally to the research process. The choice of these researchers as co-first authors acknowledges and respects this equal contribution while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Hu CL and Han X as co-first authors/Yan S and Ding Y as co-corresponding authors is appropriate for our manuscript, as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan Ding, Doctor, MD, Academic Editor, Chief Physician, Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. dingyuan@zju.edu.cn
Received: August 29, 2023
Peer-review started: August 29, 2023
First decision: September 23, 2023
Revised: September 30, 2023
Accepted: October 25, 2023
Article in press: October 25, 2023
Published online: November 27, 2023
Processing time: 90 Days and 6.6 Hours
Core Tip

Core Tip: Limited by tumor’s anatomic location and peri-vascular invasion, most perihilar cholangiocarcinoma patients lose the chance for curative treatment. In this case, we originally put forward systematic conversion therapy followed by ex vivo liver resection and autotransplantation (ELRA). The patient achieved partial response after three cycles of systemic sequential treatment without severe toxicities. Soon afterwards, ELRA, anastomotic reconstruction of the middle hepatic vein, the right hepatic vein, the root of portal vein, inferior vena cava and right hepatic artery, and lymph node dissection were performed with success. The patient achieved long time survival and has survived 22 mo following diagnosis with no evidence of recurrence or metastasis.