We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Outcome of Extended Right Hepatectomy After Biliary Drainage in Hilar Bile Duct Cancer

Shinichi Miyagawa, MD; Masatoshi Makuuchi, MD; Seiji Kawasaki, MD
Arch Surg. 1995;130(7):759-763. doi:10.1001/archsurg.1995.01430070081016.
Text Size: A A A
Published online


Objective:  Evaluation of extended right hepatectomy (ERH) after biliary drainage in patients with hilar bile duct cancer.

Design:  Case series.

Setting:  University hospital.

Patients:  Extended right hepatectomy was performed in 25 patients, and 12 underwent other surgical procedures.

Interventions:  Among the 25 patients, 16 had obstructive jaundice. After biliary drainage, 11 had no biliary stasis in both lobes and five had undrained biliary trees in the right lobe.

Main Outcome Measures:  Long-term disease-free survival, presence or absence of undrained biliary trees in each lobe, rate of decrease in serum total bilirubin levels, and future remnant liver (left lobe) volume.

Results:  Patients who underwent ERH had significantly longer disease-free survival than patients who underwent other procedures. There were no hospital deaths and no significant differences in morbidity between patients with and without prior jaundice. Patients with an undrained biliary tree in the right lobe had a larger future remnant liver volume, a slower rate of decrease in serum total bilirubin levels after biliary drainage, and a more rapid return of the postoperative serum total bilirubin level to the normal range than patients without biliary stasis in both lobes.

Conclusions:  Extended right hepatectomy can be performed safely even in patients showing a very slow decrease in the serum total bilirubin level after biliary drainage, caused by the presence of an undrained biliary tree in the right lobe with no biliary stasis in the left lobe, which induces compensatory hypertrophy of the left lobe. Extended right hepatectomy is a suitable surgical choice for achieving long-term survival in patients with hilar bile duct cancer.(Arch Surg. 1995;130:759-763)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.