Abstract
A woman in her seventies showed a mass formation in the hepatoduodenal ligament on abdominal CT. Dilatation of the intrahepatic bile ducts of both lobes was induced by the mass. Cholangiogram revealed severe stenosis from the bilateral hepatic ducts to the common hepatic duct and dilatation of the left and anterior branches of the intrahepatic bile duct, but the posterior branch was not affected. Abdominal angiography revealed stenosis from the main portal vein to the right and left bifurcation. Under the diagnosis of hilar cholangiocarcinoma with invasion to the portal vein, we performed resection of the left and caudate lobes with the portal vein and D2 lymph nodes and reconstruction. Continuous hyperthermic peritoneal perfusion (CHPP) was performed throughout, as the intraoperative cytology was class V. Histologically, this case was BsBpBmC, se, pHinf2, pGinf0, pPV2, pA (uncertain), pN1, pHM2, pDM2, pEM2, fStage IVa, and fCur C. This case was treated with adjuvant chemotherapy, internal S-1 and intravenous paclitaxel, and has now been followed postoperatively for 4 years and 10 months.
