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Recognition of individual anatomic variations is particularly important for avoiding intraoperative injury. In particular, hepatic arterial variations often restrict resection procedures. Extent of both longitudinal and vertical invasion by biliary tumors can be estimated from multiplanar reconstruction (<jats:styled-content style=\"fixed-case\">MPR<\/jats:styled-content>) images. Longitudinal extent of resection can be planned based on two anatomic landmarks, the <jats:styled-content style=\"fixed-case\">U<\/jats:styled-content> point and the <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content> point, readily identifiable in preoperative 3\u2010dimensional (3<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>) images and by intraoperative inspection. Concerning vertical invasion, when direct vascular invasion is suspected from a finding of attachment of tumor and vessels such as portal veins and\/or hepatic arteries without a thin low\u2010density plane of separation shown by <jats:styled-content style=\"fixed-case\">MPR<\/jats:styled-content>, these vessels should be resected en bloc with the tumor. Surgical team members can plan and simulate details of vascular resection and reconstruction using 3<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content> images. Reduced operative morbidity and increased <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>0 resection rates are expected because of better planning of procedures. These techniques soon may increase long\u2010term survival for patients with perihilar cholangiocarcinoma.<\/jats:p>","DOI":"10.1002\/jhbp.75","type":"journal-article","created":{"date-parts":[[2014,2,12]],"date-time":"2014-02-12T12:43:28Z","timestamp":1392209008000},"page":"525-532","source":"Crossref","is-referenced-by-count":28,"title":["Imaging and surgical planning for perihilar cholangiocarcinoma"],"prefix":"10.1002","volume":"21","author":[{"given":"Itaru","family":"Endo","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery Yokohama City University Graduate School of Medicine  3\u20109 Fukuura Kanazawa\u2010ku Yokohama 236\u20100004 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryusei","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Yokohama City University Graduate School of Medicine  3\u20109 Fukuura Kanazawa\u2010ku Yokohama 236\u20100004 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