Hepato-pancreatodudenectomy for hilar cholangiocarcinoma: a case report and literature review

Background: Hepato-pancreatodudenectomy (HPD) is the only way to achieve R0 resection for some advanced hilar cholangiocarcinoma (HCC). However, early experiences with HPD were associated with high mortality, leading to the limitation of HPD in the treatment of HCC. Case presentation: we present the case of a 62-year-old man with HCC (Bismuth IV) that achieved R0 resection by HPD which including the resection of the whole extrahepatic biliary system with the adjacent liver and pancreatoduodenum. And there was no mortality and only transient liver dysfunction happened postoperatively. Conclusions: Radical resection for HCC should not only be applied for early HCC, like Bismuth I or II, but also some advanced HCC patients. With the improvements in surgical techniques and perioperative patient care, we believe that HPD can be performed with low mortality and offers a better probability of long-term survival in patients with HCC (especially advanced HCC).