Laparoscopic surgery for perihilar cholangiocarcinoma

Abstract

Minimally invasive surgery has been widely accepted in many gastrointestinal fields, even for malignancy. However, laparoscopic resection for perihilar cholangiocarcinoma is still not universally accepted as an alternative approach for open surgery, and only a limited number of the procedures have been reported because of the difficulty of oncologic resection and a lack of consensus regarding the adequacy of this approach. Laparoscopy was initially limited to staging, biopsy and palliation. Recent technological developments and improved endoscopic procedures have greatly enlarged the application of laparoscopic liver resection and lymphadenectomy, and some reports have described laparoscopic or robot-assisted laparoscopic resection for hilar cholangiocarcinoma as feasible and safe for highly selected cases, obtaining adequate surgical margins. However, the benefits of laparoscopic major surgery have yet to be conclusively proven, and careful selection of patients is essential in order to successfully perform this procedure.