Laparoscopic Resection of Bismuth Type I and II Hilar Cholangiocarcinoma: An Audit of 14 Cases from Two Institutions

Objective: To evaluate the feasibility and safety of laparoscopic resection of Bismuth type I and II hilar cholangiocarcinoma. Background: Laparoscopic resection of hilar cholangiocarcinoma is uncommon. Method: Fourteen cases of Bismuth type land II hilar cholangiocarcinoma were selected for laparoscopic resection. Eight cases involved local resection and 6 cases included partial hepatectomy. Results: The mean operating time and blood loss were 305 min and 386 ml, respectively. The R0 resection rate was 100 and 60% in patients with type I and II lesions, respectively. The mean postoperative hospital stay was 9 days and 19 days in patients with type I and II tumor, respectively. In-hospital mortality and morbidity were 0 and 35.7% (5 of 14 patients), respectively. Bile leakage occurred in 1 of 7 (14.3%) and 3 of 5 (60%) patients with type I and II tumors, respectively. Portsite metastases were found in 2 cases of type II tumor. The survival rate during a 20-month follow-up period was 85.7% (12 of 14 patients). Conclusion: Laparoscopic resection is a potential alternative to open surgery for appropriately selected patients with Bismuth type I hilar cholangiocarcinoma. Due to the lower R0 resection and more complications, the value of laparoscopic resection for patients with type II tumors needs further evaluation. Copyright (C) 2011 S. Karger AG, Basel