Successful management of locally advanced hilar cholangiocarcinoma : Surgical procedure for extended left hepatic lobectomy coupled by resection/ reconstruction of the right hepatic artery

Recently, the methods for hepatic lobectomy, which require highly qualified and experienced surgeons and include difficult post-operative management, have improved markedly, and, moreover, there are very few patient deaths resulting from hepatic artery reconstruction. Now, as an overall trend, the focus of discussion has shifted to whether there is any positive value in radical resection. A few reports have described success in such operations. Extended left hepatectomy with right hepatic artery resection in a case of advanced hilar cholangiocarcinoma with suspected right hepatic artery invasion is reported. The surgery absolutely required reconstruction of the hepatic artery. During the postoperative course, in which the patient was at high risk for complications, temporary bleeding was observed from a pseudo aneurysm in the anastomotic site. Fortunately, no severe problems were caused by transarterial embolization in the right hepatic artery. The patient completed the planned chemotherapy regimen and was discharged.