2025 Volume 39 Issue 1 Pages 92-94
For the radical resection of locally advanced biliary tract malignancies, such as perihilar cholangiocarcinoma or gallbladder cancer with hilar involvement, portal vein reconstruction is often necessary. Recently, studies have increasingly demonstrated the efficacy and safety of this complex procedure. For biliary surgeons, developing a high level of expertise in safely and precisely executing this technique is essential.
The procedure consists of the following key steps: 1. encircling and taping of the portal vein, 2. inking the vein, 3. clamping the vein, 4. dissection of the vein, 5. applying traction with a supporting thread, 6. posterior wall suturing, 7. anterior wall suturing, and 8. tying the sutures and reperfusion. Intraoperative challenges, including risks of bleeding and thrombosis, necessitate meticulous suturing, stitching, and knotting to prevent anastomotic strictures postoperatively. Furthermore, it is vital for both the surgeon and the assistant to maintain a unified approach, working in synchrony throughout the surgery.
We hope that this article will contribute to advancements in achieving curative resections for biliary tract cancers, ultimately supporting improved patient prognoses.
