Abstract
This paper describes central hepaticojejunostomy as a new by-pass operation for unresectable carcinoma of the hapatic hilus. The bile duct at the hepatic hilus runs along the ventral side of the portal vein. It is possible to expose the intrahepatic bile duct without damaging the portal vein. The right intrahepatic bile duct is exposed beyond the cancerous region at the hepatic hilus. This method requires only a small amount of liver to be resected. Hepaticojejunoanastomosis maintains the physiological bile flow, advantageous in that cholangitis dose not occur. The quality of life for the patient is maintained. Indication for this procedure are as follows: cancer infiltration involving mainly the left hepatic duct, infiltrating to the right limited to the secondary branch, infiltration extending to the main trunk of the portal vein and unable to perform portal vein reconstruction. In our experience of 4 cases, no complications related to surgery were encountered.
