Proff. G. Tisone, A. Anselmo - Laparoscopic left hemihepatectomy with limphadenectomy for intrahepatic cholangiocellular carcinoma
ABSTRACT Background: Laparoscopic liver resection (LLR) has become an essential method for treating malignant liver tumors but there are still few reports of LLR for intrahepatic cholangiocarcinoma (IHCC). Methods: We present a video of a laparoscopic left hemihepatectomy with lymphadenectomy for the treatment of an IHCC. Case presentation: A 67 year old asymptomatic man underwent a routine abdominal ultrasound that revealed a 15x9 mm solid nodular, iso-hyperhecoic lesion, located in SIII with dilation of SII/III biliary ducts. An MRI confirmed a 32x22 mm lesion in SII/III, with mild hyperintensity on T2 weighted images and strong hypointensity on T1 weighted images. After administration of contrast medium the lesion showed light peripheral enhancement on portal and delayed phases and hypointensity on hepatospecific phase. Dilation of SII/III bile ducts. No relevant comorbidities, KPS 100. Lab tests showed normal liver function and normal Ca 19.9 levels. A laparoscopic left hemihepatectomy was planned. Results: Operative time was 330 minutes. Four intermittent cycles of pringle manouvre were applied, no blood transfusions. Postoperative course was uneventful and patient was discharged on 3d POD. Pathology report: cholangiocellular carcinoma pT1b, No. Conclusions: According to recent reports in the literature and our experience laparoscopic surgery for intrahepatic cholangiocellular carcinoma should be considered in selected patients.