Skip to main content

Anesthesia for Patients with Hilar Chlolangiocarcinoma

  • Chapter
  • First Online:
  • 1779 Accesses

Abstract

Patients with hilar cholangiocarcinoma require anesthesia for a number of surgical procedures. This ranges from minimally invasive surgery, such as diagnostic laparoscopy, to major procedures including liver transplantation. Anesthetic management in these patients is not only dependent on the magnitude of surgery, but also on any concurrent illnesses. In this chapter, we outlined the principles of anesthesia and perioperative management for patients with hilar cholangiocarcinoma undergoing a variety of surgery.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Zografos GN, Farfaras A, Zagouri F, et al. Cholangiocarcinoma: principles and current trends. Hepatobiliary Pancreat Dis Int. 2011;10:10–20.

    Article  PubMed  Google Scholar 

  2. Regimbeau JM, Fuks D, Le Treut YP, et al. Surgery for hilar cholangiocarcinoma: a multi-institutional update on practice and outcome by the AFC-HC study group. J Gastrointest Surg. 2011;15:480–8.

    Article  PubMed  Google Scholar 

  3. Cai WK, Sima H, Chen BD, et al. Risk factors for hilar cholangiocarcinoma: a case-control study in China. World J Gastroenterol. 2011;17:249–53.

    Article  PubMed  Google Scholar 

  4. Ito F, Cho CS, Rikkers LF, et al. Hilar cholangiocarcinoma: current management. Ann Surg. 2009;250:210–8.

    Article  PubMed  Google Scholar 

  5. Chamberlain RS, Blumgart LH. Hilar cholangiocarcinoma: a review and commentary. Ann Surg Oncol. 2000;7:55–66.

    Article  PubMed  CAS  Google Scholar 

  6. de Martel C, Plummer M, Franceschi S. Cholangiocarcinoma: descriptive epidemiology and risk factors. Gastroenterol Clin Biol. 2010;34:173–80.

    Article  PubMed  Google Scholar 

  7. Jonas S, Benckert C, Thelen A, et al. Radical surgery for hilar cholangiocarcinoma. Eur J Surg Oncol. 2008;34:263–71.

    Article  PubMed  CAS  Google Scholar 

  8. Hanau LH, Steigbigel NH. Acute (ascending) cholangitis. Infect Dis Clin North Am. 2000;14:521–46.

    Article  PubMed  CAS  Google Scholar 

  9. Lee JG. Diagnosis and management of acute cholangitis. Nat Rev Gastroenterol Hepatol. 2009;6:533–41.

    Article  PubMed  Google Scholar 

  10. Squizzato A, Keller T, Romualdi E, et al. Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular disease. Cochrane Database Syst Rev. 2011;19(1):CD005158.

    Google Scholar 

  11. Pulmonary Embolism Prevention (PEP) trial Collaborative Group. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet. 2000;355:1295–302.

    Article  Google Scholar 

  12. Levy JH, Azran M. Anesthetic concerns for patients with coagulopathy. Curr Opin Anaesthesiol. 2010;23:400–5.

    Article  PubMed  Google Scholar 

  13. Bradlow BA, Chetty N. Dosage frequency for suppression of platelet function by low dose aspirin therapy. Thromb Res. 1982;27:99–110.

    Article  PubMed  CAS  Google Scholar 

  14. Patrono C, Ciabattoni G, Patrignani P, et al. Clinical pharmacology of platelet cyclooxygenase inhibition. Circulation. 1985;72:1177–84.

    Article  PubMed  CAS  Google Scholar 

  15. Cheng B, Hung CT, Chiu W. Herbal medicine and anaesthesia. Hong Kong Med J. 2002;8:123–30.

    PubMed  CAS  Google Scholar 

  16. Child CG. The liver and portal hypertension. Philadelphia: Saunders; 1964.

    Google Scholar 

  17. Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60:646–9.

    Article  PubMed  CAS  Google Scholar 

  18. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464–70.

    Article  PubMed  CAS  Google Scholar 

  19. Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology. 2006;130:1652–60.

    Article  PubMed  Google Scholar 

  20. Luca A, Angermayr B, Bertolini G, et al. An integrated MELD model including serum sodium and age improves the prediction of early mortality in patients with cirrhosis. Liver Transpl. 2007;13:1174–80.

    Article  PubMed  Google Scholar 

  21. Huo TI, Wang YW, Yang YY, et al. Model for end-stage liver disease score to serum sodium ratio index as a prognostic predictor and its correlation with portal pressure in patients with liver cirrhosis. Liver Int. 2007;27:498–506.

    Article  PubMed  CAS  Google Scholar 

  22. Sakka SG. Assessing liver function. Curr Opin Crit Care. 2007;13:207–14.

    Article  PubMed  Google Scholar 

  23. Fazakas J, Mándli T, Ther G, et al. Evaluation of liver function for hepatic resection. Transplant Proc. 2006;38:798–800.

    Article  PubMed  CAS  Google Scholar 

  24. Morris-Stiff G, Gomez D, Prasad R. Quantitative assessment of hepatic function and its relevance to the liver surgeon. J Gastrointest Surg. 2009;13:374–85.

    Article  PubMed  CAS  Google Scholar 

  25. Seibel A, Müller A, Sakka SG. Indocyanine green plasma disappearance rate for monitoring hepatosplanchnic blood flow. Intensive Care Med. 2011;37:357–9.

    Article  PubMed  Google Scholar 

  26. Reekers M, Simon MJ, Boer F, et al. Pulse dye densitometry and indocyanine green plasma disappearance in ASA physical statusI-II patients. Anesth Analg. 2010;110:466–72.

    Article  PubMed  CAS  Google Scholar 

  27. Fan ST. Liver functional reserve estimation: state of the art and relevance for local treatments: the eastern perspective. J Hepatobiliary Pancreat Sci. 2010;17:380–4.

    Article  PubMed  Google Scholar 

  28. Schneider PD. Preoperative assessment of liver function. Surg Clin North Am. 2004;84:355–73.

    Article  PubMed  Google Scholar 

  29. Mann DV, Lam WW, Hjelm NM, et al. Metabolic control patterns in acute phase and regenerating human liver determined in vivo by 31-phosphorus magnetic resonance spectroscopy. Ann Surg. 2002;235:408–16.

    Article  PubMed  Google Scholar 

  30. Wakamatsu H, Nagamachi S, Kiyohara S, et al. Predictive value of Tc-99m galactosyl human serum albumin liver SPECT on the assessment of functional recovery after partial hepatectomy: a comparison with CT volumetry. Ann Nucl Med. 2010;24:729–34.

    Article  PubMed  CAS  Google Scholar 

  31. Manizate F, Hiotis SP, Labow D, et al. Liver functional reserve estimation: state of the art and relevance to local treatments. Oncology. 2010;78 Suppl 1Suppl 1:131–4.

    Article  PubMed  Google Scholar 

  32. Jakob SM. Splanchnic blood flow in low-flow states. Anesth Analg. 2003;96:1129–38.

    Article  PubMed  Google Scholar 

  33. Groszmann RJ, Abraldes JG. Portal hypertension: from bedside to bench. J Clin Gastroenterol. 2005;39(4 Suppl 2):S125–30.

    Article  PubMed  Google Scholar 

  34. Asfar P, De Backer D, Meier-Hellmann A, et al. Clinical review: influence of vasoactive and other therapies on intestinal and hepatic circulations in patients with septic shock. Crit Care. 2004;8:170–9.

    Article  PubMed  Google Scholar 

  35. Vedrinne JM, Duperret S, Bizollon T, et al. Comparison of transesophageal and transthoracic contrast echocardiography for detection of an intrapulmonary shunt in liver disease. Chest. 1997;111:1236–40.

    Article  PubMed  CAS  Google Scholar 

  36. Williams RL. Drug administration in hepatic disease. N Engl J Med. 1983;309:1616–22.

    Article  PubMed  CAS  Google Scholar 

  37. Rodighiero V. Effects of liver disease on pharmacokinetics. An update. Clin Pharmacokinet. 1999;37:399–431.

    Article  PubMed  CAS  Google Scholar 

  38. Wood M. Plasma drug binding: implications for anesthesiologists. Anesth Analg. 1986;65:786–804.

    PubMed  CAS  Google Scholar 

  39. Stoelting RK, Hiller AC. Pharmacology and physiology in anesthetic practice. Philadelphia: Lippincott Williams and Wilkins; 2006.

    Google Scholar 

  40. Merritt WT. Perioperative concerns in acute liver failure. Int Anesthesiol Clin. 2006;44:37–57.

    Article  PubMed  Google Scholar 

  41. Reichle FM, Conzen PF. Halogenated inhalational anaesthetics. Best Pract Res Clin Anaesthesiol. 2003;17:29–46.

    Article  PubMed  CAS  Google Scholar 

  42. Sinha A, Clatch RJ, Stuck G, et al. Isoflurane hepatotoxicity: a case report and review of the literature. Am J Gastroenterol. 1996;91:2406–9.

    PubMed  CAS  Google Scholar 

  43. Singhal S, Gray T, Guzman G, et al. Sevoflurane hepatotoxicity: a case report of sevoflurane hepatic necrosis and review of the literature. Am J Ther. 2010;17:219–22.

    Article  PubMed  Google Scholar 

  44. Berghaus TM, Baron A, Geier A, et al. Hepatotoxicity following desflurane anesthesia. Hepatology. 1999;29:613–4.

    Article  PubMed  CAS  Google Scholar 

  45. Myles PS, Leslie K, Silbert B, et al. A review of the risks and benefits of nitrous oxide in current anaesthetic practice. Anaesth Intensive Care. 2004;32:165–72.

    PubMed  CAS  Google Scholar 

  46. Myles PS, Leslie K, Chan MTV, ENIGMA Trial Group, et al. Avoidance of nitrous oxide for patients undergoing major surgery: a randomized controlled trial. Anesthesiology. 2007;107:221–31.

    Article  PubMed  CAS  Google Scholar 

  47. Leslie K, Myles PS, Chan MTV, et al. Risk factors for severe post-operative nausea and vomiting in a randomised trial of nitrous oxide-based versus nitrous oxide-free anaesthesia. Br J Anaesth. 2008;101:498–505.

    Article  PubMed  CAS  Google Scholar 

  48. Myles PS, Chan MTV, Leslie K, et al. Effect of nitrous oxide on plasma homocysteine and folate in patients undergoing major surgery. Br J Anaesth. 2008;100:780–6.

    Article  PubMed  CAS  Google Scholar 

  49. Graham AM, Myles PS, Leslie K, et al. A cost-benefit analysis of the ENIGMA trial. Anesthesiology. 2011;115:265–72.

    Article  PubMed  Google Scholar 

  50. Myles PS, Chan MTV, Kaye DM, et al. Effect of nitrous oxide anesthesia on plasma homocyst(e)ine and endothelial dysfunction. Anesthesiology. 2008;109:657–63.

    Article  PubMed  CAS  Google Scholar 

  51. Myles PS, Leslie K, Peyton P, ANZCA Trials Group, et al. Nitrous oxide and perioperative cardiac morbidity (ENIGMA-II) trial: rationale and design. Am Heart J. 2009;157:488–94.

    Article  PubMed  CAS  Google Scholar 

  52. Leslie K, Myles PS, Chan MTV, et al. Nitrous oxide and long-term morbidity and mortality in the ENIGMA trial. Anesth Analg. 2011;112:387–93.

    Article  PubMed  Google Scholar 

  53. Delcò F, Tchambaz L, Schlienger R, et al. Dose adjustment in patients with liver disease. Drug Saf. 2005;28:529–45.

    Article  PubMed  Google Scholar 

  54. Glass PS, Hardman D, Kamiyama Y, et al. Preliminary pharmacokinetics and pharmacodynamics of an ultra-short-acting opioid: remifentanil (GI87084B). Anesth Analg. 1993;77:1031–40.

    Article  PubMed  CAS  Google Scholar 

  55. Richardson SP, Egan TD. The safety of remifentanil by bolus injection. Expert Opin Drug Saf. 2005;4:643–51.

    Article  PubMed  CAS  Google Scholar 

  56. Grond S, Sablotzki A. Clinical pharmacology of tramadol. Clin Pharmacokinet. 2004;43:879–923.

    Article  PubMed  CAS  Google Scholar 

  57. Murphy EJ. Acute pain management pharmacology for the patient with concurrent renal or hepatic disease. Anaesth Intensive Care. 2005;33:311–22.

    PubMed  CAS  Google Scholar 

  58. Prescott LF. Paracetamol: past, present, and future. Am J Ther. 2000;7:143–7.

    Article  PubMed  CAS  Google Scholar 

  59. Craig RG, Hunter JM. Neuromuscular blocking drugs and their antagonists in patients with organ disease. Anaesthesia. 2009;64 Suppl 1Suppl 1:55–65.

    Article  PubMed  CAS  Google Scholar 

  60. Curatolo M. Adding regional analgesia to general anaesthesia: increase of risk or improved outcome? Eur J Anaesthesiol. 2010;27:586–91.

    Article  PubMed  Google Scholar 

  61. Fischer B. Benefits, risks, and best practice in regional anesthesia: do we have the evidence we need? Reg Anesth Pain Med. 2010;35:545–8.

    Article  PubMed  Google Scholar 

  62. Marret E, Remy C, Bonnet F, Postoperative Pain Forum Group. Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery. Br J Surg. 2007;94:665–73.

    Article  PubMed  CAS  Google Scholar 

  63. Park WY, Thompson JS, Lee KK. Effect of epidural anesthesia and analgesia on perioperative outcome: a randomized, controlled veterans affairs cooperative study. Ann Surg. 2001;234:560–9.

    Article  PubMed  CAS  Google Scholar 

  64. Rigg JR, Jamrozik K, Myles PS, MASTER Anaethesia Trial Study Group, et al. Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. Lancet. 2002;359:1276–82.

    Article  PubMed  Google Scholar 

  65. Peyton PJ, Myles PS, Silbert BS, et al. Perioperative epidural analgesia and outcome after major abdominal surgery in high-risk patients. Anesth Analg. 2003;96:548–51.

    PubMed  Google Scholar 

  66. Wijeysundera DN, Beattie WS, Austin PC, et al. Epidural anaesthesia and survival after intermediate-to-high risk non-cardiac surgery: a population-based cohort study. Lancet. 2008;372:562–9.

    Article  PubMed  Google Scholar 

  67. Exadaktylos AK, Buggy DJ, Moriarty DC, et al. Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis? Anesthesiology. 2006;4:660–4.

    Article  Google Scholar 

  68. Biki B, Mascha E, Moriarty DC, et al. Anesthetic technique for radical prostatectomy surgery affects cancer recurrence: a retrospective analysis. Anesthesiology. 2008;109:180–7.

    Article  PubMed  Google Scholar 

  69. Myles PS, Peyton P, Silbert B, for the ANZCA Trials Group Investigators, et al. Perioperative epidural analgesia for major abdominal surgery for cancer and recurrence-free survival: a randomised trial. BMJ. 2011;342:d1491.

    Article  PubMed  Google Scholar 

  70. Neal JM, Bernards CM, Hadzic A, et al. ASRA practice advisory on neurologic complications in regional anesthesia and pain medicine. Reg Anesth Pain Med. 2008;33:404–15.

    PubMed  Google Scholar 

  71. Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (third edition). Reg Anesth Pain Med. 2010;35:64–101.

    Article  PubMed  CAS  Google Scholar 

  72. Horlocker TT, Wedel DJ. Infectious complications of regional anesthesia. Best Pract Res Clin Anaesthesiol. 2008;22:451–75.

    Article  PubMed  Google Scholar 

  73. Richardson J, Lönnqvist PA, Naja Z. Bilateral thoracic paravertebral block: potential and practice. Br J Anaesth. 2011;106:164–71.

    Article  PubMed  CAS  Google Scholar 

  74. Siddiqui MR, Sajid MS, Uncles DR, et al. A meta-analysis on the clinical effectiveness of transversus abdominis plane block. J Clin Anesth. 2011;23:7–14.

    Article  PubMed  Google Scholar 

  75. Forastiere E, Sofra M, Giannarelli D, et al. Effectiveness of continuous wound infusion of 0.5 % ropivacaine by On-Q pain relief system for postoperative pain management after open nephrectomy. Br J Anaesth. 2008;101:841–7.

    Article  PubMed  CAS  Google Scholar 

  76. Goodnough LT. Autologous blood donation. Anesthesiol Clin North America. 2005;23:263–70.

    Article  PubMed  Google Scholar 

  77. Maithel SK, Jarnagin WR. Adjuncts to liver surgery: is acute normovolemic hemodilution useful for major hepatic resections? Adv Surg. 2009;43:259–68.

    Article  PubMed  Google Scholar 

  78. Pape A, Habler O. Alternatives to allogeneic blood transfusions. Best Pract Res Clin Anaesthesiol. 2007;2:221–39.

    Article  CAS  Google Scholar 

  79. Carless PA, Henry DA, Moxey AJ, et al. Cell salvage for minimizing perioperative allogeneic blood transfusion. Cochrane Database Syst Rev. 2010(4):CD001888.

    Google Scholar 

  80. Gurusamy KS, Li J, Sharma D, et al. Pharmacological interventions to decrease blood loss and blood transfusion requirements for liver resection. Cochrane Database Syst Rev. 2009(4):CD008085.

    Google Scholar 

  81. Ghaferi AA, Birkmeyer JD, Dimick JB. Variation in hospital mortality associated with inpatient surgery. N Engl J Med. 2009;361:1368–75.

    Article  PubMed  CAS  Google Scholar 

  82. Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100:1043–9.

    Article  PubMed  CAS  Google Scholar 

  83. Devereaux PJ, Chan MTV, Eikelboom J. Major vascular complications in patients undergoing non-cardiac surgery: magnitude of the problem, risk prediction, surveillance, and prevention. In: Yusuf S, Cairns JA, Camm AJ, et al., editors. Evidence based cardiology. 3rd ed. West Sussex: Wiley-Blackwell; 2010. p. 47–62.

    Google Scholar 

  84. Devereaux PJ, Pogue J, Guyatt G, et al. Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. Ann Intern Med. 2011;154(8):523–8.

    Article  PubMed  CAS  Google Scholar 

  85. Devereaux PJ, Yang H, Yusuf S, on behalf of POISE Investigators, et al. Effects of metoprolol succinate extended-release in patients undergoing noncardiac surgery: a randomised controlled trial. Lancet. 2008;371:1839–47.

    Article  PubMed  CAS  Google Scholar 

  86. Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011;149:713–24.

    Article  PubMed  Google Scholar 

  87. Ginès P, Guevara M, Arroyo V, et al. Hepatorenal syndrome. Lancet. 2003;362:1819–27.

    Article  PubMed  CAS  Google Scholar 

  88. Bamji N, Cohen LB. Endoscopic sedation of patients with chronic liver disease. Clin Liver Dis. 2010;14:185–94.

    Article  PubMed  Google Scholar 

  89. Williams EJ, Taylor S, Fairclough P, BSG Audit of ERCP, et al. Are we meeting the standards set for endoscopy? Results of a large-scale prospective survey of endoscopic retrograde cholangio-pancreatograph practice. Gut. 2007;56:821–9.

    Article  PubMed  Google Scholar 

  90. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002;96:1004–17.

    Article  Google Scholar 

  91. Heuss LT, Drewe J, Schnieper P, et al. Patient-controlled versus nurse-administered sedation with propofol during colonoscopy. A prospective randomized trial. Am J Gastroenterol. 2004;99:511–8.

    Article  PubMed  Google Scholar 

  92. Campbell L, Imrie G, Doherty P, et al. Patient maintained sedation for colonoscopy using a target controlled infusion of propofol. Anaesthesia. 2004;59:127–32.

    Article  PubMed  CAS  Google Scholar 

  93. Chen SC, Rex DK. An initial investigation of bispectral monitoring as an adjunct to nurse-administered propofol sedation for colonoscopy. Am J Gastroenterol. 2004;99:1081–6.

    Article  PubMed  Google Scholar 

  94. Chui PT, Gin T, Oh TE. Anaesthesia for laparoscopic general surgery. Anaesth Intensive Care. 1993;21:163–71.

    PubMed  CAS  Google Scholar 

  95. Cunningham AJ. Anesthetic implications of laparoscopic surgery. Yale J Biol Med. 1998;71:551–78.

    PubMed  CAS  Google Scholar 

  96. Gerges FJ, Kanazi GE, Jabbour-Khoury SI. Anesthesia for laparoscopy: a review. J Clin Anesth. 2006;18:67–78.

    Article  PubMed  CAS  Google Scholar 

  97. Alkozai EM, Lisman T, Porte RJ. Bleeding in liver surgery: prevention and treatment. Clin Liver Dis. 2009;13:145–54.

    Article  PubMed  Google Scholar 

  98. Schroeder RA, Kuo PC. Pro: low central venous pressure during liver transplantation—not too low. J Cardiothorac Vasc Anesth. 2008;22:311–4.

    Article  PubMed  Google Scholar 

  99. Massicotte L, Beaulieu D, Thibeault L. Con: low central venous pressure during liver transplantation. J Cardiothorac Vasc Anesth. 2008;22:315–7.

    Article  PubMed  Google Scholar 

  100. Kim YK, Chin JH, Kang SJ, et al. Association between central venous pressure and blood loss during hepatic resection in 984 living donors. Acta Anaesthesiol Scand. 2009;53:601–6.

    Article  PubMed  CAS  Google Scholar 

  101. Lau WY, Lai EC, Lau SH. Methods of vascular control technique during liver resection: a comprehensive review. Hepatobiliary Pancreat Dis Int. 2010;9:473–81.

    PubMed  Google Scholar 

  102. Fu SY, Lau WY, Li AJ, et al. Liver resection under total vascular exclusion with or without preceding Pringle manoeuvre. Br J Surg. 2010;97:50–5.

    Article  PubMed  Google Scholar 

  103. Chui AK, Island ER, Rao AR, et al. The longest survivor and first potential cure of an advanced cholangiocarcinoma by ex vivo resection and autotransplantation: a case report and review of the literature. Am Surg. 2003;69:441–4.

    PubMed  CAS  Google Scholar 

  104. Fu SY, Lai EC, Li AJ, et al. Liver resection with selective hepatic vascular exclusion: a cohort study. Ann Surg. 2009;249:624–7.

    Article  PubMed  Google Scholar 

  105. De Vreede I, Steers JL, Burch PA, et al. Prolonged disease-free survival after orthotopic liver transplantation plus adjuvant chemoirradiation for cholangiocarcinoma. Liver Transpl. 2000;6:309–16.

    Article  PubMed  Google Scholar 

  106. Rea DJ, Heimbach JK, Rosen CB, et al. Liver transplantation with neoadjuvant chemoradiation is more effective than resection for hilar cholangiocarcinoma. Ann Surg. 2005;242:451–8.

    PubMed  Google Scholar 

  107. Ozier Y, Klinck JR. Anesthetic management of hepatic transplantation. Curr Opin Anaesthesiol. 2008;21:391–400.

    Article  PubMed  Google Scholar 

  108. Della Rocca G, Brondani A, Costa MG. Intraoperative hemodynamic monitoring during organ transplantation: what is new? Curr Opin Organ Transplant. 2009;14:291–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. T. V. Chan MBBS, FANZCA, FHKCA, FHKAM .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media Dordrecht and People's Medical Publishing House

About this chapter

Cite this chapter

Ho, S.S., Chan, M.T.V. (2013). Anesthesia for Patients with Hilar Chlolangiocarcinoma. In: Lau, W. (eds) Hilar Cholangiocarcinoma. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6473-6_15

Download citation

  • DOI: https://doi.org/10.1007/978-94-007-6473-6_15

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-6472-9

  • Online ISBN: 978-94-007-6473-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics