Minimally-invasive Right Hepatectomy for Perihilar Cholangiocarcinoma

The magnification of images provided by minimally-invasive surgery (MIS) allows a very sharp and precise dissection of the hepatic hilum, allowing to overcome the technical complexity of surgery of perihilar cholangiocarcinoma (PHC). Recently, the feasibility and reproducibility of MIS for PHC are reported: within centers with adequate expertise and respecting the cornerstones of oncological adequacy, it provides short term advantages in a selected population of patients. The video reports the case of a patient with PHC involving the right biliary duct and requiring right hepatectomy with biliary confluence and segment 1 resection, with associated lymphadenectomy. Current evidences, together with feasibility and reproducibility of the technique shown in this video, appear promising and constitute a good prerequisite for the further implementation of this approach to improve patients outcome while following the principles of surgical oncology in hilar cholangiocarcinoma.