Eric C H Lai

Second Military Medical University, Shanghai, Shanghai, Shanghai Shi, China

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Publications (123)281.91 Total impact

  • Eric C H Lai · Chung Ngai Tang
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    ABSTRACT: Robotic system has been increasingly used in pancreatectomy. However, the effectiveness of this method remains uncertain. This study compared the surgical outcomes between robot-assisted laparoscopic distal pancreatectomy and conventional laparoscopic distal pancreatectomy. During a 15-year period, 35 patients underwent minimally invasive approach of distal pancreatectomy in our center. Seventeen of these patients had robot-assisted laparoscopic approach, and the remaining 18 had conventional laparoscopic approach. Their operative parameters and perioperative outcomes were analyzed retrospectively in a prospective database. The mean operating time in the robotic group (221.4 min) was significantly longer than that in the laparoscopic group (173.6 min) (P = 0.026). Both robotic and conventional laparoscopic groups presented no significant difference in spleen-preservation rate (52.9% vs. 38.9%) (P = 0.505), operative blood loss (100.3 ml vs. 268.3 ml) (P = 0.29), overall morbidity rate (47.1% vs. 38.9%) (P = 0.73), and post-operative hospital stay (11.4 days vs. 14.2 days) (P = 0.46). Both groups also showed no perioperative mortality. Similar outcomes were observed in robotic distal pancreatectomy and conventional laparoscopic approach. However, robotic approach tended to have the advantages of less blood loss and shorter hospital stay. Further studies are necessary to determine the clinical position of robotic distal pancreatectomy.
    No preview · Article · Aug 2015 · Frontiers of Medicine
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    ABSTRACT: To further improve the effectiveness and prognosis of primary hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT), the current status of treatment for HCC with PVTT was reviewed. A Medline search was undertaken to identify articles using the keywords "HCC", "PVTT" and "therapy". Additional papers were identified by a manual search of the references from the key articles. PVTT, as a common complication of HCC, was divided into type I∼IV. The therapeutic approach is mainly composed of five types: surgical resection, regional interventional therapy, radiotherapy, combination therapy, targeted therapy. All of these therapeutic approaches were separately evaluated in detail. For those resectable tumors, the better choice for treatment of HCC with PVTT should be hepatectomy and removal of PVTT. For those unresectable tumors, TACE (especially the super-selective TACE) has been the preferred palliative treatment, the other regional interventional therapy and/or radiotherapy could improve the therapeutic effects. The multidisciplinary treatments may further improve the quality of life and prolong the survival period for the HCC patients associated with PVTT. Copyright © 2015. Published by Elsevier Ltd.
    No preview · Article · May 2015 · International Journal of Surgery (London, England)
  • Eric C.H. Lai · Chung Ngai Tang
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    ABSTRACT: To report our experience in palliative hepaticojejunostomy for advanced malignant biliary obstruction by means of robotic approach METHODS: Robot-assisted laparoscopic hepaticojejunostomy for advanced malignant biliary obstruction was performed in nine patients from May 2009 to April 2014. During the study period, robotic hepaticojejunostomy for advanced malignant biliary obstruction was completed successfully in nine patients. Roux-en-Y hepaticojejunostomy and double (hepaticojejunostomy, and gastrojejunostomy) bypass were performed in five and four patients, respectively. The mean operating time was 212.8 minutes. The mean blood loss was 38.7 mL. The overall complication rate was 22.2%. Bile leak complication occurred in one patient only. There was no procedure-related mortality. The mean postoperative hospital stay was 13.3 days. Five patients received palliative systemic chemotherapy after bypass surgery. The mean survival time was 11.1 months. During follow up, only three patients with cholangiocarcinoma had recurrent biliary obstruction after end-to-side hepaticojejunostomy due to tumor progression, and needed percutaneous transhepatic biliary drainage. Among these nine patients, there were a total of eight episodes of readmission in four patients due to tumor-related symptoms or complications. Robot-assisted laparoscopic hepaticojejunostomy for advanced malignant biliary obstruction had a low complication rate and was associated with an improved quality of life. Copyright © 2015. Published by Elsevier Taiwan.
    No preview · Article · Mar 2015
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    Nam Hung Chia · Eric C.H. Lai · Wan Yee Lau
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    ABSTRACT: INTRODUCTION Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been developed for patients with predicted insufficient future liver remnant volumes to induce more rapid hepatic hypertrophy and increase resectability. In the medical literature, the use of ALPPS in hepatocellular carcinoma (HCC) has rarely been reported. PRESENTATION OF CASE We reported the use of ALPPS in a patient with primarily unresectable HCC arising from a background of hepatitis B related liver fibrosis. Preoperative computed tomography (CT) showed 2 large conglomerated tumors measuring 16 cm × 10.5 cm in liver segments 5, 6, 7 and 8, and at least 3 satellite nodules with the largest one measuring 3 cm around the main tumor and another 4 cm tumor in segment 4. Right trisectionectomy after ALPPS was successfully performed. He was discharged from hospital on postoperative day 13 after the second operation. Follow-up CT scan at 6 weeks after the second operation showed further hypertrophy of the liver remnant and no liver recurrence. DISCUSSION Our case showed that this novel strategy is feasible even in the context of a background of chronic hepatitis B related liver fibrosis, although the hypertrophy rate was a little bit slower and the time needed was longer. CONCLUSION ALPPS is also feasible in liver fibrosis. It gives hope to patients with HCC who previously were considered as having unresectable diseases. More studies are needed to further evaluate the effectiveness and oncological outcomes of ALPPS from these patients.
    Preview · Article · Nov 2014 · International Journal of Surgery Case Reports
  • Eric C. H. Lai · Stephanie H.Y. Lau · Wan Yee Lau
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    ABSTRACT: Background Surgery on patients with malignant obstructive jaundice carries increased risks of postoperative morbidity and mortality. Preoperative biliary drainage has been developed to reduce this procedure-related risks, but its role in patients who are going to receive pancreaticoduodenectomy for periampullary carcinoma is still controversial. Methods This article aimed at reviewing the current status of preoperative biliary drainage for patients with peri-ampullary tumors who were candidates for pancreaticoduodenectomy. A MEDLINE and PubMed database search from 1980 to 2013 was performed to identify relevant articles using the keywords “pancreaticoduodenectomy”, “preoperative biliary drainage”, “jaundice”, “peri-ampullary neoplasm” and “carcinoma of pancreas”. Additional papers were identified by a manual search of the references from the key articles. Results There were six randomized controlled trials (RCTs) and 5 meta-analyses on preoperative biliary drainage for patients with malignant obstructive jaundice. Most of the results of these studies could not be used to define the role of preoperative biliary drainage for patients who received pancreaticoduodenectomy for periampullary carcinoma because: first, the majority of these studies were on bypass or palliative resections; second, various pathologies with both proximal and distal biliary obstruction were included; third, there were different forms of percutaneous or endoscopic drainage procedures; fourth, there were different durations of preoperative drainage; and finally, there were variations in the definition of events and outcomes. There was only one RCT which included a homogeneous group of patients with carcinoma of pancreas who underwent pancreaticoduodenectomy. For patients with periampullary tumor, the RCTS and meta-analyses showed no benefit of preoperative biliary drainage. Instead, there were some concerns about the drainage-related complications and the increase in positive intraoperative bile culture rate and the associated infective complication rate postoperatively. Conclusion Routine preoperative biliary drainage showed no beneficial effect on the surgical outcome for patients with periampullary tumor. A selective approach of preoperative biliary drainage should be adopted for these patients. The optimal duration and modality of preoperative biliary drainage remain unclear.
    No preview · Article · Oct 2014 · The surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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    ABSTRACT: Introduction: Laparoscopic liver resection under hemihepatic vascular inflow occlusion has advantages over the conventional Pringle's maneuver, especially in patients with cirrhosis. However, laparoscopic hemihepatic vascular inflow occlusion is technically challenging. Subjects and methods: From March 2013 to August 2013, 8 consecutive patients who underwent laparoscopic liver resection under right hemivascular inflow occlusion using the lowering of the hilar plate approach. Results: There were 3 women and 5 men, with a mean age of 52.6 years (range, 44-73 years). The pathologies were hepatocellular carcinoma (n=3), sarcomatoid liver carcinoma (n=1), hepatic vascular epithelial tumor (n=1), hemangioma (n=2), and colorectal liver metastases (n=1). The types of resection included right hepatectomy (n=3), right anterior sectionectomy (n=1), segments 5 and 6 resection (n=1), and segment 6 resection (n=2). All patients underwent right hemivascular inflow occlusion. The mean operation time was 186.2 minutes (range, 100-280 minutes). The mean time taken to prepare for hemivascular inflow occlusion was 17.8 minutes (range, 15-20 minutes). The mean intraoperative blood loss was 218.8 mL (range, 100-300 mL). The mean duration of vascular control was 25.6 minutes (range, 15-40 minutes). No patients developed postoperative liver failure. There was no postoperative morbidity or mortality. The mean hospital stay was 6 days (range, 5-7 days). Conclusions: Hemihepatic vascular inflow occlusion using the lowering of the hilar plate approach was safe and feasible. It facilitated laparoscopic liver resection by minimizing blood loss during liver parenchymal transection.
    No preview · Article · Sep 2014 · Journal of Laparoendoscopic & Advanced Surgical Techniques
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    ABSTRACT: Introduction. Both hepatocellular carcinoma (HCC) presenting during pregnancy and HCC presenting with obstructive jaundice due to a tumor cast in the biliary tract are very rare. The management of these patients remains challenging. Presentation of Case. A 23-year-old lady presented with obstructive jaundice at 38 weeks of gestation. Investigations showed HCC with a biliary tumor thrombus. She received percutaneous transhepatic biliary drainage (PTBD) and caesarean section. Right hepatectomy, extrahepatic bile duct resection, and left hepaticojejunostomy were carried out when the jaundice improved. The postoperative course was uneventful. She was discharged home on postoperative day 10. Histopathology showed HCC with a tumor thrombus in the bile duct. The surgical margins were clear. One year after surgery, the mother was disease-free and the baby was well. Conclusion. With proper management, curative treatment is possible in a pregnant patient who presented with obstructive jaundice due to a biliary tumor thrombus from HCC.
    Preview · Article · Aug 2014
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    ABSTRACT: Hemoperitoneum is a rare and potentially life-threatening complication of GIST. We reported a 54-year-old man who developed disseminated intra-abdominal recurrence from a previously resected gastrointestinal stromal tumour (GIST) of the small bowel, and the patient presented with hemoperitoneum. Emergent debulking surgery was performed. A high dose imatinib was prescribed. Despite the presence of residual disease, the patient was well clinically 8 months after the operation. Even though, there is no evidence to support the routine use of debulking surgery in the management of GIST. In our patient, disease progression after second line targeted therapy and the absence of alternative treatment options for spontaneous rupture and hemoperitoneum prompted us to treat the patient aggressively. Resection of the ruptured GIST was carried out for control of bleeding and to prevent recurrent bleeding in this patient with good surgical risks. During the treatment decision-making, the patient's general condition, the risk of surgery and the extent of dissemination were taken into consideration. In this patient who presented with spontaneous rupture of a small intestinal GIST, the novel use of targeted therapy and aggressive surgical treatment produced reasonably good survival outcome.
    No preview · Article · Jul 2014 · Frontiers of Medicine
  • Yong-jun Chen · Eric C.H. Lai · Wan-Yee Lau · Xiao-ping Chen
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    ABSTRACT: Techniques for reconstruction of pancreatic stump with gastrointestinal tract following pancreaticoduodenectomy are closely related to postoperative complications, mortality and quality of life. In order to reduce postoperative complications, particularly pancreatic fistula, many modifications and new surgical techniques have been proposed to replace the traditional pancreaticojejunostomy and pancreaticogastrostomy. The objective of this review, based on large prospective randomized trials and meta-analyses, is to evaluate the different techniques of enteric reconstruction of pancreatic stump following pancreaticoduodenectomy, including: invagination pancreaticojejunostomy, binding pancreaticojejunostomy, duct-to-mucosa pancreaticojejunostomy, Roux-en-Y pancreaticojejunostomy, and pancreaticogastrostomy, so as to provide a comprehensive comparison of these techniques and to assess of their roles and effectiveness.
    No preview · Article · Jul 2014 · International Journal of Surgery
  • Eric C H Lai · Chung-Ngai Tang
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    ABSTRACT: Purpose: To evaluate the technical feasibility and safety of robot-assisted laparoscopic partial caudate lobe resection using the robotic surgical system. Materials and methods: This is a report of the use of robot-assisted laparoscopic partial caudate lobe resection on 2 patients with hepatocellular carcinoma. Results: Robot-assisted laparoscopic partial caudate lobe resection was completed successfully in these 2 patients. The operating time was 137 and 150 minutes, respectively. The blood loss was 137 and 150 mL, respectively. They were able to tolerate liquids on the second postoperative day. Both patients recovered from the operation. They were discharged 4 and 5 days after the operation, respectively. The resected margins of both specimens were tumor free (R0 resections). Conclusions: Robot-assisted laparoscopic partial caudate lobe resection is a feasible and safe procedure. Our results demonstrate the advantages of robotic system on short-term outcomes and suggest the extended indication of minimally invasive hepatectomy even in the technically challenging anatomic area.
    No preview · Article · Jun 2014 · Surgical laparoscopy, endoscopy & percutaneous techniques
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    ABSTRACT: The aim of this randomized comparative trial (RCT) is to compare partial hepatectomy (PH) with transcatheter arterial chemoembolization (TACE) to treat patients with resectable multiple hepatocellular carcinoma (RMHCC) outside of Milan Criteria. This RCT was conducted on 173 patients with RMHCC outside of Milan Criteria (a solitary tumor up to 5 cm or multiple tumors up to 3 in number and up to 3 cm for each tumor) who were treated in our centre from November 2008 to September 2010. The patients were randomly assigned to the PH group or the TACE group. The primary outcome measure was overall survival (OS) from the date of treatment. A multivariate Cox proportional hazards regression analysis was performed to assess the prognostic risk factors associated with OS. The 1-, 2- and 3- year OS rates were 76.1%, 63.5% and 51.5%, respectively, for the PH group compared with 51.8%, 34.8% and 18.1%, respectively, for the TACE group(log-rank test,χ2=24.246,P < 0.001).Multivariate Cox proportional hazards regression analysis revealed the type of treatment (hazard ratio, 0.434; 95% CI, 0.293 to 0.644,P < 0.001), number of tumor (hazard ratio, 1.758; 95% CI, 1.213 to 2.548,P=0.003) and gender (hazard ratio, 0.451; 95% CI, 0.236 to 0.862,P=0.016) were significant independent risk factors associated with OS. PH provided better OS for patients with RMHCC outside of Milan Criteria than conventional TACE. The number of tumor and gender were also independent risk factors associated with OS for RMHCC.
    Full-text · Article · Mar 2014 · Journal of Hepatology
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    ABSTRACT: A study of 7,388 consecutive patients after hepatic resection between 2011 and 2012 identified hepatolithiasis, cirrhosis, and intraoperative blood transfusion as the only independent risk factors of both incisional and organ/space surgical site infection (SSI). Patients with these conditions should be cared for with caution to lower SSI rates.
    Full-text · Article · Mar 2014 · Infection Control and Hospital Epidemiology
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    ABSTRACT: Massive blood loss remains a problem during resection for giant liver hemangioma. This present study was designed to compare selective hepatic vascular exclusion (SHVE) versus Pringle maneuver in surgery for liver hemangioma compressing the major (right, middle, or left) hepatic veins. From January 2003 to December 2011, 589 consecutive patients with hemangioma underwent liver resection in our department, and 273 patients had their tumors compressing at least one of the three major hepatic veins (right, middle, or left). Either SHVE (n = 120 patients) or Pringle maneuver (n = 153 patients) was used to minimize blood loss during resection. Data regarding the intraoperative and postoperative courses of these patients were retrospectively analyzed. There was no significant difference between the two groups of patients regarding age, sex, tumor size, types of hepatectomy, and extent of tumor involvement of the major hepatic veins. Intraoperative blood loss, transfusion requirements, and transfusion volume were significantly less in the SHVE group (P < 0.01). For the Pringle group, major hepatic veins were lacerated in 19 patients during hepatic parenchymal transection. For the SHVE group, a major hepatic vein was lacerated during extrahepatic dissection of the hepatic vein in two patients and during hepatic parenchymal transection in 14 patients. SHVE was more efficacious in minimizing intraoperative bleeding during liver resection for hemangiomas compressing the major hepatic veins. It prevented intraoperative major bleeding and air embolism and significantly decreased postoperative liver failure and in-hospital mortality.
    No preview · Article · Mar 2014 · The American surgeon
  • Eric C H Lai

    No preview · Article · Nov 2013 · Frontiers of Medicine
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    T Yang · Y F Sun · J Zhang · W Y Lau · E C H Lai · J H Lu · F Shen · M C Wu
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    ABSTRACT: Improvements in surgical technique and perioperative care have made partial hepatectomy a safe and effective treatment for hepatocellular carcinoma (HCC), even in the event of spontaneous HCC rupture. A consecutive cohort of patients who underwent partial hepatectomy for HCC between 2000 and 2009 was divided into a ruptured group and a non-ruptured group. Patients with ruptured HCC were further divided into emergency and staged hepatectomy subgroups. Mortality and morbidity, overall survival and recurrence-free survival (RFS) were compared. Prognostic factors for overall survival and RFS were identified by univariable and multivariable analyses. A total of 1233 patients underwent partial hepatectomy for HCC, of whom 143 had a ruptured tumour. The morbidity and mortality rates were similar in the ruptured and non-ruptured groups, as well as in the emergency and staged subgroups. In univariable analyses, overall survival and RFS were lower in the ruptured group than in the non-ruptured group (both P < 0·001), and also in the emergency subgroup compared with the staged subgroup (P = 0·016 and P = 0·025 respectively). In multivariable analysis, spontaneous rupture independently predicted poor overall survival after hepatectomy (hazard ratio 1·54, 95 per cent confidence interval 1·24 to 1·93) and RFS (HR 1·75, 1·39 to 2·22). Overall survival and RFS after hepatectomy for ruptured HCC in the emergency and staged subgroups were not significantly different in multivariable analyses. Spontaneous rupture predicted poor long-term survival after hepatectomy for HCC, but surgical treatment seems possible, safe and appropriate in selected patients.
    Full-text · Article · Jul 2013 · British Journal of Surgery
  • Eric C.H. Lai · George P.C. Yang · Chung Ngai Tang
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    ABSTRACT: Background: This study aimed at analyzing the perioperative and early survival outcomes of robotic liver resection of hepatocellular carcinoma (HCC). Methods: The study population included a consecutive series of patients with HCC who underwent robotic liver resection at a single center. Results: During the study period, 41 consecutive patients with HCC underwent 42 robotic liver resections. Five resections (11.9%) were carried out for recurrent HCC, and 23.8% (n = 10) were hemihepatectomy procedures. The mean operating time and blood loss was 229.4 minutes and 412.6 mL, respectively. The R0 resection rate was 93%. The hospital mortality and morbidity rates were 0% and 7.1%, respectively. The mean hospital stay was 6.2 days. The 2-year overall and disease-free survival rates were 94% and 74%, respectively. In the subgroup analysis of minor liver resection, when compared with the conventional laparoscopic approach, the robotic group had similar blood loss (mean, 373.4 mL vs 347.7 mL), morbidity rate (3% vs 9%), mortality rate (0% vs 0%), and R0 resection rate (90.9% vs 90.9%). However, the robotic group had a significantly longer operative time (202.7 mins vs 133.4 mins). Conclusions: This study demonstrated the feasibility and safety of robotic surgery for HCC, with favorable short-term outcome. However, the long-term oncologic results remain uncertain.
    No preview · Article · Apr 2013 · American journal of surgery
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    ABSTRACT: Background: The aim of this study was to compare the results of surgical resection with three-dimensional conformal radiotherapy (3D-CRT) in the treatment of resectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Transarterial chemoembolization (TACE) was given to both groups of patients when possible. Methods: A retrospective study of 371 patients with resectable HCC with PVTT was conducted in two tertiary referral centers. The treatment of choice for these patients in one center was surgical resection. In the other center it was 3D-CRT. In the radiotherapy group (RG, n = 185), patients received 3D-CRT to the tumor and PVTT for a total radiation dose of 30-52 Gy (median 40 Gy). In the surgical group (SG, n = 186), patients underwent surgical resection. TACE was applied after surgery or 3D-CRT and then was repeated every 4-6 weeks if the patient tolerated the treatment. Results: The median survival was 12.3 months for RG and 10.0 months for SG. The 1-, 2-, and 3-year overall survivals were 51.6, 28.4, and 19.9 %, respectively, for RG and 40.1, 17.0, and 13.6 %, respectively, for SG (p = 0.029). Stepwise multivariate analysis showed that the extent of PVTT and mode of treatment were independent risk factors of overall survival. The most common cause of death after treatment was liver failure as a consequence of progressive intrahepatic disease. Conclusions: 3D-CRT gave better survival than surgical resection for HCC with PVTT.
    No preview · Article · Mar 2013 · World Journal of Surgery
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    ABSTRACT: Mirizzi syndrome is an uncommon cause of common hepatic duct obstruction resulting from gallstone impaction in the cystic duct or gallbladder neck. Mirizzi syndrome is traditionally considered as a contraindication to laparoscopic surgery mainly due to risk of bile duct injury during dissection. We present the surgical experience of 5 patients with Mirizzi syndrome who were diagnosed preoperatively and managed using minimally access surgical technique, either total laparoscopic or robotic-assisted laparoscopic approach. All patients had successful operations and recovered without complications. We concluded that with a correct preoperative diagnosis, careful operative strategy, increasing expertise with laparoscopic technique, and introduction of robotic surgical system, minimally invasive approach of management of Mirizzi syndrome becomes safe and feasible.
    No preview · Article · Feb 2013 · Surgical laparoscopy, endoscopy & percutaneous techniques
  • E. C. H. Lai · S. H. Y. Lau · W. Y. Lau
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    ABSTRACT: Tumors at the biliary confluence at the hilum of the liver (also called Klatskin tumors) comprise 40-60 % of all cholangiocarcinomas. The preoperative evaluation of a patient with suspected hilar cholangiocarcinoma is directed toward the following four primary objectives: (1) an assessment of the extent and level of biliary tract and vascular involvement including portal vein and hepatic artery involvement; (2) an assessment of the liver for evidence of lobar atrophy or concomitant liver pathology; (3) an assessment of the extent or presence of nodal disease and/or distant metastases; and (4) an assessment of the patients overall fitness for operation. The three primary goals in the surgical management of hilar cholangiocarcinoma are complete tumor excision with negative histological margins, relief of symptoms relating to biliary obstruction, and restoration of bilioenteric continuity [1, 2]. However, these are only achievable in the minority of patients (20∼30 %). When advanced local disease, or obvious extrahepatic metastases are identified preoperatively or at the time of laparotomy, therapeutic interventions are directed toward the relief of biliary obstruction and its associated symptoms and complications such as itching, cholangitis, and liver failure in order to improve the quality of life. Different modalities are currently available to drain the biliary system and include endoscopic, percutaneous, and surgical bypass. The best technique remains controversial. Endoscopic biliary drainage can be achieved by plastic (polyethylene) or metallic stents. However, endoscopic stenting for hilar malignancies is associated with a high failure rate. Percutaneous insertion of a biliary stent can be preferable for hilar cholangiocarcinoma as the stent placement is more predictable than with an endoscopic approach. Intrahepatic biliary-enteric bypass has an advantage in this regard since the anastomosis can be placed some distance from the primary tumor, but requires a major operative procedure with associated morbidity. Surgery is associated with greater early morbidity and mortality but greater long-term patency and a lower incidence of recurrent jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the preferred method if unresectability is determined before surgery. If unresectability or the presence of metastatic disease is identified at laparotomy, palliative options include postoperative placement of transhepatic stents, operatively placed transtumoral stents, or the performance of an operative bilioenteric bypass. When deciding among these options, the general physical condition, age of the patient, and predicted life expectancy must be considered. Within the literature, there have been insufficient data to show whether a surgical or a non-surgical approach provides the more cost effective and better palliation [3, 4]. The lack of randomized data and the heterogeneity within studies makes any direct comparisons difficult. These studies need to be interpreted with caution also. The study population between the surgical and nonsurgical groups was dissimilar with the better risk patients receiving operative palliation and those with poor risk, advanced disease or severe co-morbidities referred for non-operative biliary drainage. © Springer Science+Business Media Dordrecht and People's Medical Publishing House 2013. All rights are reserved.
    No preview · Chapter · Jan 2013
  • W. Y. Lau · S. H. Y. Lau · E. C. H. Lai
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    ABSTRACT: A thorough knowledge of anatomy around the hepatic hilus is essential to carry out surgery on hilar cholangiocarcinoma. © Springer Science+Business Media Dordrecht and People's Medical Publishing House 2013. All rights are reserved.
    No preview · Chapter · Jan 2013

Publication Stats

3k Citations
281.91 Total Impact Points


  • 2009-2014
    • Second Military Medical University, Shanghai
      • Department of Anesthesiology
      Shanghai, Shanghai Shi, China
  • 2001-2014
    • The Chinese University of Hong Kong
      • • Department of Surgery
      • • Prince of Wales Hospital
      Hong Kong, Hong Kong
  • 2001-2005
    • Prince of Wales Hospital, Hong Kong
      Chiu-lung, Kowloon City, Hong Kong