Initial experience of total laparoscopic radical resection for Bismuth type IIIa hilar cholangiocarcinoma: a report of three cases

Objective To analyze the initial experience of total laparoscopic radical resection for patients with Bismuth type IIIa hilar cholangiocarcinoma. Methods A retrospective study was conducted to analyze the clinical data of three patients with Bismuth type IIIa hilar cholangiocarcinomatotal who underwent laparoscopic radical resection in Zhejiang Provincial People’s Hospital from February to May in 2017. Results The three patients all underwent the operations successfully. The operation time ranged from 490.0 to 580.0 min. The intraoperative blood loss ranged from 300.0 ml to 1 200.0 ml. There was no severe perioperative complication or death. One patient developed biliary leakage which responded to drainage without reoperation. Another patient developed pleural effusion treated with minimal invasive drainage. The length of postoperative hospital stay ranged from 10.0 to 18.0 days. Histopathology showed two patients with well-differentiated adenocarcinomas and one patient with poorly differentiated adenocarcinoma. The number of lymph nodes harvested ranged from 8~13. Two patients had no regional lymph node metastasis and one patient had regional lymph node metastasis (1/13). The hilar bile duct resection margins of the three patients were all negative. There was no evidence of tumor recurrence on following up for 7~10 months. Conclusions It was safe and feasible to carry out total laparoscopic radical resection in selected patients with Bismuth type IIIa hilar cholangiocarcinoma. More patients and longer follow-up are required to study the long term oncological results. Key words: Hilar cholangiocarcinoma; Laparoscopic surgery; Radical resection; Bismuth Ⅲa