Surgical Approaches to Primary Cholangiocarcinoma at the Junction of the Common Hepatic Duct (Klatskin Tumors)

This videotape presents a combined tumour and liver resection in cholangiocarcinoma of the porta hepatis, the tumour being large and embracing the common hepatic duct and its confluence and extending to both right and left of the main hepatic ducts. It invades the left branch of the portal vein as well as the entire left hepatic duct. The porta hepatis is dissected, followed by cholecystectomy. The richt hepatic duct is dissected proximal from the tumour and far form the confluence of the common hapatic duct. Apart from resecting the tumour, liver resection embracing the segments 2,3,4 is performed. By taking frozen biopsies from the transsected margins of the segmental main hepatic duct the radicality of the resection can be evaluated. Postoperative cholangiography reveals the patterns of the intrahepatic cholangiojejunostomies.