Resection of a cholangiocarcinoma via laparoscopic hepatopancreato- duodenectomy: A case report

Figure 1 Enhanced computed tomography and magnetic resonance cholangiopancreatography findings related to the tumor. A-C: Computed tomography scan revealed stenosis of the hepatic and upper common bile duct as well as irregular thickening of the common bile duct wall (white arrow); D: Magnetic resonance cholangiopancreatography showed obstruction of the common bile duct (white arrow).

Figure 2 Key surgical steps of laparoscopic hepatopancreatoduodenectomy. A: The duodenum was invaded by the tumor (white arrow); B: The inferior border of the pancreatic neck was dissected and a retropancreatic tunnel was created; C: The operative view after laparoscopic pancreaticoduodenectomy. The white arrow head indicates the opening of the right hepatic duct; arrow indicates the opening of the left hepatic duct; D: Laparoscopic hepatopancreatoduodenectomy was completed.

Figure 3 Resected specimen following laparoscopic pancreaticoduodenectomy.

Figure 4 Bile duct was opened from Vater's ampulla to the proximal duct stump. Arrow head, left hepatic duct; arrow right, hepatic duct; T, the tumor had spread from the hepatic portal to the distal part of common bile duct 1.5 cm from Vater's ampulla.

Figure 5 Specimen of laparoscopic right hemihepatectomy. White arrows show the right anterior segmental duct and the right posterior segmental duct.