Management of hilar cholangiocarcinoma - Addressing key issues in surgical planning

Managing hilar cholangiocarcinoma is tricky and one of the most challenging surgical planning tasks. This video by Dr. Prasad Wagle, Senior gastrointestinal and hepatobiliary surgeon in Mumbai, Maharashtra, tackles the most commonly faced challenges in planning the surgery/ treatment for hilar cholangiocarcinoma.

The video begins with the anatomy of the hilum and caudate lobe to the Bismuth Corlette classification as well as the Jarnagin classification which is the more relevant one. Following this is the discussion on the surgical margins and feasibility as well as the role of preoperative biliary drainage. This is followed by a discussion on the different clinical scenarios and specific management options for portal vein involvement, arterial involvement, inadequate future liver remnant, and neoadjuvant therapy.

The safe limits for hepatic resection at different bilirubin levels are next discussed. Overall, this video gives a complete overview on the relevant issues in the management of hilar cholangiocarcinoma.

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