Clinical Implications of Biliary Confluence Pattern for Bismuth-Corlette Type IV Hilar Cholangiocarcinoma Applied to Hemihepatectomy
Background Since biliary variations are commonly seen, our aims are to clarify these insidious variations and discuss their surgicopathologic implications for Bismuth-Corlette (BC) type IV hilar cholangiocarcinoma (HC) applied to hemihepatectomy. Methods Three-dimensional images of patients with dis...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2017-04, Vol.21 (4), p.666-675 |
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| creator | Ji, Gu-wei Zhu, Fei-peng Wang, Ke Jiao, Chen-yu Shao, Zi-cheng Li, Xiang-cheng |
| description | Background
Since biliary variations are commonly seen, our aims are to clarify these insidious variations and discuss their surgicopathologic implications for Bismuth-Corlette (BC) type IV hilar cholangiocarcinoma (HC) applied to hemihepatectomy.
Methods
Three-dimensional images of patients with distal bile duct obstruction (
n
= 97) and advanced HC (
n
= 79) were reconstructed and analyzed retrospectively. Normal biliary confluence pattern was defined as the peripheral segment IV duct (B4) joining the common trunk of segment II (B2) and segment III (B3) ducts to form the left hepatic duct (LHD) that then joined the right hepatic duct (RHD). The lengths from left and right secondary biliary ramifications to the right side of the umbilical portion of the left portal vein (Rl-L) and the cranio-ventral side of the right portal vein (Rr-R) were measured, respectively, and compared with the resectable bile duct length in HCs. Surgicopathologic findings were compared between different BC types.
Results
The resectable bile duct length in right hemihepatectomy for eradication of type IV tumors was significantly longer than the Rl-L length in normal biliary configuration (17.4 ± 1.8 and 10.3 ± 3.4 mm, respectively,
p
|
| doi_str_mv | 10.1007/s11605-017-3377-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1865827112</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1865827112</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-f47e362ad3eee4fc986488c0bbf3c6746eaf9cd12eb556728d033cb6ebf76ef83</originalsourceid><addsrcrecordid>eNp1kU1v1DAQhi0EoqXwA7ggS1y4BPyR2M6xRMCuVAkOBXGLHGfcdeXYwXYOe-eH49UWhJA4eeR55p2PF6GXlLylhMh3mVJBuoZQ2XAuZcMeoUuqJG9awcTjGpOeNqzrvl-gZznfkwoSqp6iC6aoUEK2l-jn4F1wRnu8X1Zfg-JiyDha_N55p9MRDzFYv0EwgL_oUiAFbGOq6bxs5dAMMXmo3_j2uALef8M753XCwyF6He5cNDoZF-Ki8fVaG8CMS8Q7WNwBVl3AlLgcn6MnVvsMLx7eK_T144fbYdfcfP60H65vGsMlK41tJXDB9MwBoLWmV6JVypBpstzUbQRo25uZMpi6TkimZsK5mQRMVgqwil-hN2fdNcUfG-QyLi4b8HVSiFseqRKdYpJSVtHX_6D3cUuhTlcp2XOlWtVXip4pk2LOCey4JrfUq42UjCeLxrNFY738eLJoPCm_elDepgXmPxW_PakAOwO5psIdpL9a_1f1FzHMnjk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1879388489</pqid></control><display><type>article</type><title>Clinical Implications of Biliary Confluence Pattern for Bismuth-Corlette Type IV Hilar Cholangiocarcinoma Applied to Hemihepatectomy</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Ji, Gu-wei ; Zhu, Fei-peng ; Wang, Ke ; Jiao, Chen-yu ; Shao, Zi-cheng ; Li, Xiang-cheng</creator><creatorcontrib>Ji, Gu-wei ; Zhu, Fei-peng ; Wang, Ke ; Jiao, Chen-yu ; Shao, Zi-cheng ; Li, Xiang-cheng</creatorcontrib><description>Background
Since biliary variations are commonly seen, our aims are to clarify these insidious variations and discuss their surgicopathologic implications for Bismuth-Corlette (BC) type IV hilar cholangiocarcinoma (HC) applied to hemihepatectomy.
Methods
Three-dimensional images of patients with distal bile duct obstruction (
n
= 97) and advanced HC (
n
= 79) were reconstructed and analyzed retrospectively. Normal biliary confluence pattern was defined as the peripheral segment IV duct (B4) joining the common trunk of segment II (B2) and segment III (B3) ducts to form the left hepatic duct (LHD) that then joined the right hepatic duct (RHD). The lengths from left and right secondary biliary ramifications to the right side of the umbilical portion of the left portal vein (Rl-L) and the cranio-ventral side of the right portal vein (Rr-R) were measured, respectively, and compared with the resectable bile duct length in HCs. Surgicopathologic findings were compared between different BC types.
Results
The resectable bile duct length in right hemihepatectomy for eradication of type IV tumors was significantly longer than the Rl-L length in normal biliary configuration (17.4 ± 1.8 and 10.3 ± 3.4 mm, respectively,
p
< 0.001), and type III variation (B2 joining the common trunk of B3 and B4) was the predominant configuration (53.8%). The resectable length in left hemihepatectomy for eradication of type IV tumors was comparable with the Rr-R length in RHD absent cases (15.2 ± 2.5 and 16.4 ± 2.6 mm, respectively,
p
= 0.177) but significantly longer than that in normal configuration (
p
< 0.001). The estimated length was 8.5 ± 2.0 mm in unresectable cases. There was no significant difference between type III and IV tumors, except for the rate of nodal metastasis (29.7 and 76.0%, respectively,
p
< 0.001).
Conclusion
Hemihepatectomy might be selected for curative-intent resection of BC type IV tumors considering the advantageous biliary variations, whereas anatomical trisegmentectomy is recommended for the resectable bile duct length less than 10 mm. Biliary variations might result in excessive classification of BC type IV but require validation on further study.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-017-3377-2</identifier><identifier>PMID: 28168674</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anatomic Landmarks ; Bile Duct Neoplasms - diagnostic imaging ; Bile Duct Neoplasms - pathology ; Bile Duct Neoplasms - surgery ; Bile ducts ; Bile Ducts, Intrahepatic - anatomy & histology ; Bile Ducts, Intrahepatic - diagnostic imaging ; Bile Ducts, Intrahepatic - surgery ; Bismuth ; Cholangiocarcinoma ; Cholestasis - diagnostic imaging ; Cholestasis - surgery ; Female ; Gastroenterology ; Hepatectomy - methods ; Hepatic Duct, Common - anatomy & histology ; Hepatic Duct, Common - diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; Klatskin Tumor - diagnostic imaging ; Klatskin Tumor - secondary ; Klatskin Tumor - surgery ; Male ; Medicine ; Medicine & Public Health ; Metastasis ; Middle Aged ; Organ Size ; Original Article ; Portal Vein - anatomy & histology ; Portal Vein - diagnostic imaging ; Retrospective Studies ; Surgery ; Tumors ; Veins & arteries</subject><ispartof>Journal of gastrointestinal surgery, 2017-04, Vol.21 (4), p.666-675</ispartof><rights>The Society for Surgery of the Alimentary Tract 2017</rights><rights>Journal of Gastrointestinal Surgery is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-f47e362ad3eee4fc986488c0bbf3c6746eaf9cd12eb556728d033cb6ebf76ef83</citedby><cites>FETCH-LOGICAL-c372t-f47e362ad3eee4fc986488c0bbf3c6746eaf9cd12eb556728d033cb6ebf76ef83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-017-3377-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-017-3377-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28168674$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ji, Gu-wei</creatorcontrib><creatorcontrib>Zhu, Fei-peng</creatorcontrib><creatorcontrib>Wang, Ke</creatorcontrib><creatorcontrib>Jiao, Chen-yu</creatorcontrib><creatorcontrib>Shao, Zi-cheng</creatorcontrib><creatorcontrib>Li, Xiang-cheng</creatorcontrib><title>Clinical Implications of Biliary Confluence Pattern for Bismuth-Corlette Type IV Hilar Cholangiocarcinoma Applied to Hemihepatectomy</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
Since biliary variations are commonly seen, our aims are to clarify these insidious variations and discuss their surgicopathologic implications for Bismuth-Corlette (BC) type IV hilar cholangiocarcinoma (HC) applied to hemihepatectomy.
Methods
Three-dimensional images of patients with distal bile duct obstruction (
n
= 97) and advanced HC (
n
= 79) were reconstructed and analyzed retrospectively. Normal biliary confluence pattern was defined as the peripheral segment IV duct (B4) joining the common trunk of segment II (B2) and segment III (B3) ducts to form the left hepatic duct (LHD) that then joined the right hepatic duct (RHD). The lengths from left and right secondary biliary ramifications to the right side of the umbilical portion of the left portal vein (Rl-L) and the cranio-ventral side of the right portal vein (Rr-R) were measured, respectively, and compared with the resectable bile duct length in HCs. Surgicopathologic findings were compared between different BC types.
Results
The resectable bile duct length in right hemihepatectomy for eradication of type IV tumors was significantly longer than the Rl-L length in normal biliary configuration (17.4 ± 1.8 and 10.3 ± 3.4 mm, respectively,
p
< 0.001), and type III variation (B2 joining the common trunk of B3 and B4) was the predominant configuration (53.8%). The resectable length in left hemihepatectomy for eradication of type IV tumors was comparable with the Rr-R length in RHD absent cases (15.2 ± 2.5 and 16.4 ± 2.6 mm, respectively,
p
= 0.177) but significantly longer than that in normal configuration (
p
< 0.001). The estimated length was 8.5 ± 2.0 mm in unresectable cases. There was no significant difference between type III and IV tumors, except for the rate of nodal metastasis (29.7 and 76.0%, respectively,
p
< 0.001).
Conclusion
Hemihepatectomy might be selected for curative-intent resection of BC type IV tumors considering the advantageous biliary variations, whereas anatomical trisegmentectomy is recommended for the resectable bile duct length less than 10 mm. Biliary variations might result in excessive classification of BC type IV but require validation on further study.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anatomic Landmarks</subject><subject>Bile Duct Neoplasms - diagnostic imaging</subject><subject>Bile Duct Neoplasms - pathology</subject><subject>Bile Duct Neoplasms - surgery</subject><subject>Bile ducts</subject><subject>Bile Ducts, Intrahepatic - anatomy & histology</subject><subject>Bile Ducts, Intrahepatic - diagnostic imaging</subject><subject>Bile Ducts, Intrahepatic - surgery</subject><subject>Bismuth</subject><subject>Cholangiocarcinoma</subject><subject>Cholestasis - diagnostic imaging</subject><subject>Cholestasis - surgery</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatectomy - methods</subject><subject>Hepatic Duct, Common - anatomy & histology</subject><subject>Hepatic Duct, Common - diagnostic imaging</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional</subject><subject>Klatskin Tumor - diagnostic imaging</subject><subject>Klatskin Tumor - secondary</subject><subject>Klatskin Tumor - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Organ Size</subject><subject>Original Article</subject><subject>Portal Vein - anatomy & histology</subject><subject>Portal Vein - diagnostic imaging</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Tumors</subject><subject>Veins & arteries</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1v1DAQhi0EoqXwA7ggS1y4BPyR2M6xRMCuVAkOBXGLHGfcdeXYwXYOe-eH49UWhJA4eeR55p2PF6GXlLylhMh3mVJBuoZQ2XAuZcMeoUuqJG9awcTjGpOeNqzrvl-gZznfkwoSqp6iC6aoUEK2l-jn4F1wRnu8X1Zfg-JiyDha_N55p9MRDzFYv0EwgL_oUiAFbGOq6bxs5dAMMXmo3_j2uALef8M753XCwyF6He5cNDoZF-Ki8fVaG8CMS8Q7WNwBVl3AlLgcn6MnVvsMLx7eK_T144fbYdfcfP60H65vGsMlK41tJXDB9MwBoLWmV6JVypBpstzUbQRo25uZMpi6TkimZsK5mQRMVgqwil-hN2fdNcUfG-QyLi4b8HVSiFseqRKdYpJSVtHX_6D3cUuhTlcp2XOlWtVXip4pk2LOCey4JrfUq42UjCeLxrNFY738eLJoPCm_elDepgXmPxW_PakAOwO5psIdpL9a_1f1FzHMnjk</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Ji, Gu-wei</creator><creator>Zhu, Fei-peng</creator><creator>Wang, Ke</creator><creator>Jiao, Chen-yu</creator><creator>Shao, Zi-cheng</creator><creator>Li, Xiang-cheng</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170401</creationdate><title>Clinical Implications of Biliary Confluence Pattern for Bismuth-Corlette Type IV Hilar Cholangiocarcinoma Applied to Hemihepatectomy</title><author>Ji, Gu-wei ; Zhu, Fei-peng ; Wang, Ke ; Jiao, Chen-yu ; Shao, Zi-cheng ; Li, Xiang-cheng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-f47e362ad3eee4fc986488c0bbf3c6746eaf9cd12eb556728d033cb6ebf76ef83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anatomic Landmarks</topic><topic>Bile Duct Neoplasms - diagnostic imaging</topic><topic>Bile Duct Neoplasms - pathology</topic><topic>Bile Duct Neoplasms - surgery</topic><topic>Bile ducts</topic><topic>Bile Ducts, Intrahepatic - anatomy & histology</topic><topic>Bile Ducts, Intrahepatic - diagnostic imaging</topic><topic>Bile Ducts, Intrahepatic - surgery</topic><topic>Bismuth</topic><topic>Cholangiocarcinoma</topic><topic>Cholestasis - diagnostic imaging</topic><topic>Cholestasis - surgery</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatectomy - methods</topic><topic>Hepatic Duct, Common - anatomy & histology</topic><topic>Hepatic Duct, Common - diagnostic imaging</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional</topic><topic>Klatskin Tumor - diagnostic imaging</topic><topic>Klatskin Tumor - secondary</topic><topic>Klatskin Tumor - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Organ Size</topic><topic>Original Article</topic><topic>Portal Vein - anatomy & histology</topic><topic>Portal Vein - diagnostic imaging</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Tumors</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ji, Gu-wei</creatorcontrib><creatorcontrib>Zhu, Fei-peng</creatorcontrib><creatorcontrib>Wang, Ke</creatorcontrib><creatorcontrib>Jiao, Chen-yu</creatorcontrib><creatorcontrib>Shao, Zi-cheng</creatorcontrib><creatorcontrib>Li, Xiang-cheng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ji, Gu-wei</au><au>Zhu, Fei-peng</au><au>Wang, Ke</au><au>Jiao, Chen-yu</au><au>Shao, Zi-cheng</au><au>Li, Xiang-cheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Implications of Biliary Confluence Pattern for Bismuth-Corlette Type IV Hilar Cholangiocarcinoma Applied to Hemihepatectomy</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>21</volume><issue>4</issue><spage>666</spage><epage>675</epage><pages>666-675</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
Since biliary variations are commonly seen, our aims are to clarify these insidious variations and discuss their surgicopathologic implications for Bismuth-Corlette (BC) type IV hilar cholangiocarcinoma (HC) applied to hemihepatectomy.
Methods
Three-dimensional images of patients with distal bile duct obstruction (
n
= 97) and advanced HC (
n
= 79) were reconstructed and analyzed retrospectively. Normal biliary confluence pattern was defined as the peripheral segment IV duct (B4) joining the common trunk of segment II (B2) and segment III (B3) ducts to form the left hepatic duct (LHD) that then joined the right hepatic duct (RHD). The lengths from left and right secondary biliary ramifications to the right side of the umbilical portion of the left portal vein (Rl-L) and the cranio-ventral side of the right portal vein (Rr-R) were measured, respectively, and compared with the resectable bile duct length in HCs. Surgicopathologic findings were compared between different BC types.
Results
The resectable bile duct length in right hemihepatectomy for eradication of type IV tumors was significantly longer than the Rl-L length in normal biliary configuration (17.4 ± 1.8 and 10.3 ± 3.4 mm, respectively,
p
< 0.001), and type III variation (B2 joining the common trunk of B3 and B4) was the predominant configuration (53.8%). The resectable length in left hemihepatectomy for eradication of type IV tumors was comparable with the Rr-R length in RHD absent cases (15.2 ± 2.5 and 16.4 ± 2.6 mm, respectively,
p
= 0.177) but significantly longer than that in normal configuration (
p
< 0.001). The estimated length was 8.5 ± 2.0 mm in unresectable cases. There was no significant difference between type III and IV tumors, except for the rate of nodal metastasis (29.7 and 76.0%, respectively,
p
< 0.001).
Conclusion
Hemihepatectomy might be selected for curative-intent resection of BC type IV tumors considering the advantageous biliary variations, whereas anatomical trisegmentectomy is recommended for the resectable bile duct length less than 10 mm. Biliary variations might result in excessive classification of BC type IV but require validation on further study.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28168674</pmid><doi>10.1007/s11605-017-3377-2</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of gastrointestinal surgery, 2017-04, Vol.21 (4), p.666-675 |
| issn | 1091-255X 1873-4626 |
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| subjects | Adult Aged Aged, 80 and over Anatomic Landmarks Bile Duct Neoplasms - diagnostic imaging Bile Duct Neoplasms - pathology Bile Duct Neoplasms - surgery Bile ducts Bile Ducts, Intrahepatic - anatomy & histology Bile Ducts, Intrahepatic - diagnostic imaging Bile Ducts, Intrahepatic - surgery Bismuth Cholangiocarcinoma Cholestasis - diagnostic imaging Cholestasis - surgery Female Gastroenterology Hepatectomy - methods Hepatic Duct, Common - anatomy & histology Hepatic Duct, Common - diagnostic imaging Humans Imaging, Three-Dimensional Klatskin Tumor - diagnostic imaging Klatskin Tumor - secondary Klatskin Tumor - surgery Male Medicine Medicine & Public Health Metastasis Middle Aged Organ Size Original Article Portal Vein - anatomy & histology Portal Vein - diagnostic imaging Retrospective Studies Surgery Tumors Veins & arteries |
| title | Clinical Implications of Biliary Confluence Pattern for Bismuth-Corlette Type IV Hilar Cholangiocarcinoma Applied to Hemihepatectomy |
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