{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T21:49:36Z","timestamp":1771710576549,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,12,8]],"date-time":"2014-12-08T00:00:00Z","timestamp":1417996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Major hepatectomy with concomitant pancreatoduodenectomy (major\u2010<jats:styled-content style=\"fixed-case\">HPD<\/jats:styled-content>) is the only procedure that provides a curative resection for diffusely spread extrahepatic bile duct cancer (<jats:styled-content style=\"fixed-case\">DSEBDC<\/jats:styled-content>). We sometimes encounter patients who cannot undergo major\u2010<jats:styled-content style=\"fixed-case\">HPD<\/jats:styled-content> because of a poor functional hepatic reserve. The aim of the present study was to assess the feasibility of central hepatectomy with pancreatoduodenectomy (central\u2010<jats:styled-content style=\"fixed-case\">HPD<\/jats:styled-content>) for patients with <jats:styled-content style=\"fixed-case\">DSEBDC<\/jats:styled-content> as an alternative to major\u2010<jats:styled-content style=\"fixed-case\">HPD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2002 and 2010, six patients with <jats:styled-content style=\"fixed-case\">DSEBDC<\/jats:styled-content> underwent central\u2010<jats:styled-content style=\"fixed-case\">HPD<\/jats:styled-content>. The hepatectomy procedures for central\u2010<jats:styled-content style=\"fixed-case\">HPD<\/jats:styled-content> included central bisectionectomy with <jats:styled-content style=\"fixed-case\">S1<\/jats:styled-content> resection (<jats:styled-content style=\"fixed-case\">S1r<\/jats:styled-content>) and right anterior sectionectomy with <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>1r.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The estimated resection liver volume was decreased from 77.5% to 46.6% by the application of central\u2010<jats:styled-content style=\"fixed-case\">HPD<\/jats:styled-content>. The median operative duration was 929\u2009min, and the median blood loss was 2568\u2009ml. Postoperative complications were observed in five patients. The proximal ductal stump was histologically positive with non\u2010invasive cancer in three patients and positive with invasive cancer in one. The overall survival of the six patients was 62.5% at 5 years after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While central\u2010<jats:styled-content style=\"fixed-case\">HPD<\/jats:styled-content> was a technically complicated procedure associated with a high morbidity rate, it offered a favorable overall survival and might be an alternative option for <jats:styled-content style=\"fixed-case\">DSEBDC<\/jats:styled-content> patients with a poor hepatic functional reserve.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.197","type":"journal-article","created":{"date-parts":[[2014,12,9]],"date-time":"2014-12-09T07:34:43Z","timestamp":1418110483000},"page":"287-293","source":"Crossref","is-referenced-by-count":10,"title":["Central hepatectomy with pancreatoduodenectomy for diffusely spread bile duct cancer"],"prefix":"10.1002","volume":"22","author":[{"given":"Takashi","family":"Mizuno","sequence":"first","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Shizuoka Cancer Center Hospital  1007 Shimonagakubo Nagaizumi\u2010cho Sunto\u2010gun Shizuoka 411\u20108777 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideyuki","family":"Kanemoto","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Shizuoka Cancer Center Hospital  1007 Shimonagakubo Nagaizumi\u2010cho Sunto\u2010gun Shizuoka 411\u20108777 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teiichi","family":"Sugiura","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Shizuoka Cancer Center Hospital  1007 Shimonagakubo Nagaizumi\u2010cho Sunto\u2010gun Shizuoka 411\u20108777 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiyasu","family":"Okamura","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Shizuoka Cancer Center Hospital  1007 Shimonagakubo Nagaizumi\u2010cho Sunto\u2010gun Shizuoka 411\u20108777 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhiko","family":"Uesaka","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Shizuoka Cancer Center Hospital  1007 Shimonagakubo Nagaizumi\u2010cho Sunto\u2010gun Shizuoka 411\u20108777 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,8]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"923","article-title":"Our experiences (5 cases) of extended right lobectomy combined with pancreatoduodenectomy for the carcinoma of the gall bladder (in Japanese)","volume":"1","author":"Takasaki K","year":"1980","journal-title":"Tan to Sui"},{"key":"e_1_2_6_3_1","first-page":"170","article-title":"Hepatopancreatoduodenectomy for advanced carcinoma of the biliary tract","volume":"38","author":"Nimura Y","year":"1991","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810139"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900014"},{"key":"e_1_2_6_6_1","first-page":"1634","article-title":"Diffuse bile duct carcinoma treated by major hepatectomy and pancreatoduodenectomy with the aid of pre\u2010operative portal vein embolization. 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