Total three-dimensional laparoscopic radical resection for Bismuth type Ⅳ hilar cholangiocarcinoma

作者：Yang-Sui Liu; Dun-Feng Qi; Jun Zhang; Huan-Song Li; Xin-Cun Jiang; Long Cui^*

来源：Hepatobiliary and Pancreatic Diseases International, 2023, 22(05): 541-546.

<正>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 typeⅣHCCA 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.