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| Total three-dimensional laparoscopic radical resection for Bismuth type IV hilar cholangiocarcinoma |
| Yang-Sui Liu, Dun-Feng Qi, Jun Zhang, Huan-Song Li, Xin-Cun Jiang, Long Cui ∗ |
Department of Hepatobiliary Surgery, Xuzhou Central Hospital, Xuzhou 221009, China
∗ Corresponding author.
E-mail address: lboclong@aliyun.com (L. Cui) . |
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Abstract Hilar cholangiocarcinoma (HCCA) (also known as Klatskin tumor) has a poor prognosis worldwide, and accounts for more than half of cholangiocarcinoma cases. HCCA originates from epithelium and often arises from the confluence of the bile ducts or the right or left hepatic ducts [ 1 , 2 ]. Because of its aggressiveness and refractory biological characteristics, the median survival time of patients with unresectable HCCA is less than 1 year. Radical resection is the most effective treatment for HCCA. Surgery for Bismuth type IV HCCA requires radical lymphadenectomy, corresponding hemihepatectomy combined with caudate lobectomy, resection of extrahepatic bile duct, and hepaticojejunostomy for biliary reconstruction to achieve long-term patient survival [ 3 , 4 ]. Due to the difficult surgical procedure and specific malignant biological behaviors of HCCA, laparoscopic radical resection of HCCA has been implemented only in specific and highly selective cases [5–8] . However, surgeons work in a three-dimensional (3D) space under the guidance of traditional two-dimensional (2D) laparoscopy, which lacks true depth perception and spatial orientation, potentially increasing the risk of surgical complications and the duration of surgery. The development of 3D high-definition laparoscopy for surgical application offers surgeons a better and clearer depth of surgical field and improves hand-eye coordination. Some studies have reported that 3D laparoscopy can effectively reduce performance errors, operative time, and intraoperative and postoperative complications and shorten the time required for surgical novices to learn new surgical procedures compared with 2D laparoscopy [9–11] . We recently first implemented 3D laparoscopy radical resection for Bismuth type IV HCCA for selected patients into our daily routine, and the results were encouraging. In this report, we documented the use of 3D high-definition laparoscopy in radical Bismuth type IV HCCA surgery in a patient and assessed the patient’s recovery over a 3-month follow-up period.
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2023, Vol. 22 
