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Updated: Jan 20, 2026

Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
Published on: May 23, 2025
Ex situ liver resection and autotransplantation for advanced cholangiocarcinoma
Ashish George1,2, Ashwin Rammohan1,2, Srinivas Mettu Reddy1,2
1Institute of Liver Disease & Transplantation, Dr. Rela Institute & Medical Centre, Sree Balaji Medical College Hospital, Bharat Institute of Higher Education & Research, Chennai, Tamil Nadu, India.
Abstract:
Advanced cholangiocarcinoma especially those involving the vasculature have extremely limited options of cure. Ex situ liver resection entails performing a total hepatectomy, resecting the tumour on the back-table followed by reimplantation (autotransplantation) of the liver. Application of this technique for these tumours has rarely been done due to complexity of the procedure and the dismal prognosis of the lesions. We present our experience of two cases of advanced intrahepatic cholangiocarcinoma with limited extrahepatic disease who underwent ex situ resection with autotransplantation. They underwent preoperative therapy with a waiting period to assess the tumour biology. Both patients underwent ex situ resection with extended hepatectomy on the back table. Both patients remain well on follow-up 24 months and 20 months, respectively, with excellent quality of life. Despite its technical complexity, ex situ liver resection may offer prolonged overall survival in selected patients with advanced cholangiocarcinoma and limited extrahepatic disease.
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