Catalogo Articoli (Spogli Riviste)


S4a+S5 with caudate lobe (S1) resection using the Taj Mahal liver parenchymal resection for carcinoma of the biliary tract
Kawarada, Y; Isaji, S; Taoka, H; Tabata, M; Das, BC; Yokoi, H;
Mie Univ, Sch Med, Dept Surg 1, Tsu, Mie 5148507, Japan Mie Univ Tsu Mie Japan 5148507 Med, Dept Surg 1, Tsu, Mie 5148507, Japan
Titolo Testata:
fascicolo: 4, volume: 3, anno: 1999,
pagine: 369 - 373
biliary tract carcinoma; Taj Mahal liver resection; surgical technique; curative resection;
Tipo documento:
Settore Disciplinare:
Clinical Medicine
Indirizzi per estratti:
Indirizzo: Kawarada, Y Mie Univ, Sch Med, Dept Surg 1, Tsu, Mie 5148507, Japan Mie Univ Tsu Mie Japan 5148507 urg 1, Tsu, Mie 5148507, Japan
Y. Kawarada et al., "S4a+S5 with caudate lobe (S1) resection using the Taj Mahal liver parenchymal resection for carcinoma of the biliary tract", J GASTRO S, 3(4), 1999, pp. 369-373


Recently we have been performing S4a + S5 with total resection of the caudate lobe (S1) by using a dome-like dissection along the root of the middle hepatic vein at the pinnacle, which we refer to as the Taj Mahal liver parenchymal resection, for carcinoma of the biliary tract. This procedure offers the following advantages: (1) It allows total resection of the caudate lobe, including the paracaval portion (S9), and (2) because the cut surface of the liver is large, it allows intrahepatic jejunostomy to be performed more easily with a good field of view The indications for this procedure include hilar bile duct carcinoma,, gallbladder carcinoma, and choledochal cyst(type IVA). Because of the high rate of hilar liver parenchyma and caudatelobe invasion associated with hilar bile duct carcinoma, the liver must beresected. The Taj Mahal procedure is indicated in cases where extended liver resection is impossible. The dissection limits of this procedure are, onthe left side, the B2 + 3 bifurcation at the right margin of the umbilicalportion of the portal vein and, on the right side, the B8 of the anterior branch and the B6 + 7 bifurcation of the right posterior branch. This procedure could also be described as a reduced form of extended right hepatectomy and extended left hepatectomy. For gallbladder carcinoma, this procedure is indicated to ensure an adequate surgical margin and eradicate transvenous liver metastasis, particularly in cases of pT2 lesions. Hilar and caudatelobe invasion also occurs in liver bed-type gallbladder carcinoma, and bile duct resection and caudate lobe resection are required for the surgery tobe curative. We performed this procedure in four cases of hilar bile duct carcinoma, five cases of gallbladder carcinoma, and one case each of choledochal cyst (type IVA) with carcinoma of the bile duct and gallbladder adenomyomatosis. Curative resection was possible in all except the patient with adenomyomatosis, and all of the patients are alive and recurrence free 10 to 37 months postoperatively. This procedure, in addition to preserving liver function, provides a wide field of view and facilitates reconstruction ofmultiple intrahepatic bile ducts. Thus it can be said to be a curative operation not only in patients considered high risk but also in those whose hilar bile duct carcinoma is limited to the bifurcation area (Bismuth type IIIa and IIIb) and in gallbladder carcinoma up to pT2 with slight extension on the hepatic side.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 01:15:22