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Chapter-07 Evaluation and Management of Hepatic Hilar Blocks

BOOK TITLE: Gastrointestinal Surgery Series: Pancreas and Hepatobiliary Surgery

Author
1. Kumaran Vinay
ISBN
9789352702602
DOI
10.5005/jp/books/14149_8
Edition
1/e
Publishing Year
2018
Pages
14
Author Affiliations
1. Sir Ganga Ram Hospital, New Delhi, India, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
Chapter keywords
Hepatic hilar block, endoscopic cholangiopancreatography, ERCP, gallbladder carcinoma, neoadjuvant chemotherapy, cholangiocarcinoma, chemoradiotherapy, percutaneous transhepatic biliary drainage, PTBD

Abstract

This chapter focuses on evaluation and management of hepatic hilar blocks. A hilar block is typically diagnosed in a patient who presents with jaundice and is found on imaging to have bile ducts dilated in the liver with a block at the level of the junction of the left and right hepatic ducts. The cause is commonly cancer of the gallbladder or bile duct. Benign causes are less common. This chapter discusses diagnosis, staging, and surgical treatment of these tumors, briefly review the role of adjuvant therapy and identify the rare benign causes of hilar blocks. Initial blood investigations would include complete blood counts, liver functions tests, renal function tests, and a prothrombin time.

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