Background/purpose: Right hepatectomy is indicated for hilar cholangiocarcinoma, but mobilization of the right lobe could be difficult when perihepatic adhesion develops in response to repeated cholangitis and forceful mobilization may disseminate bacteria if the obstructed biliary tract contains pus. We encountered a patient who died from postoperative sepsis and multiorgan failure.
Methods: To circumvent such a difficulty, we employed the anterior approach right hepatectomy in a second patient with hilar cholangiocarcinoma. In this patient, liver transection and division of the hepatic vein were performed before mobilization of the right lobe.
Results: The second patient recovered uneventfully.
Conclusion: The anterior approach (utilizing the "no-touch" technique) may be a preferred procedure for right hepatectomy for hilar cholangiocarcinoma.