A Novel Technique of Surgery for Perihilar Cholangiocarcinoma: Extended Right-sided Hepatectomy sparing Segment 3 and 4 with Utilizing Rex Shunt (H125678-B-PV)

A Novel Technique to Overcome the Limitations of Surgery for Perihilar Cholangiocarcinoma: Extended Right-sided Hepatectomy sparing Segment 3 and 4 with Utilizing Rex Shunt (H125678-B-PV)

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

JPRN

Registry ID

JPRN-jRCT1030250261

Enrollment

Registered

2025-07-29

Start date

2017-03-30

Completion date

Unknown

Last updated

2026-06-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Perihilar cholangiocarcinoma

Interventions

Extended right hepatectomy preserving segments 3 and 4 (H125678-B-PV) with Rex shunt

D018285

Perihilar cholangiocarcinoma

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Patients with perihilar cholangiocarcinoma (PHC) without distant metastasis or extra-regional lymph node involvement 2.1 Right-dominant Bismuth type IV tumors where negative bile duct margins could not be achieved by right trisectionectomy but were expected to be obtained by transecting bile ducts B3 and B4 at the dorsal level of the umbilical portion (UP) of the portal vein 2.2 Right-dominant tumors with portal vein (PV) invasion extending to P2, where achieving a cancer-negative margin or performing vascular reconstruction at that site would be difficult, but sparing P3+4 at the UP was feasible. 3. Future liver remnant (FLR) volume >35% of total liver volume. 4. Indocyanine green-Krem (ICG-Krem) value >0.05. 5. Sufficient physiological tolerance for major hepatectomy (based on performance status and comorbidities).

Exclusion criteria

Exclusion criteria: 1. Presence of distant metastasis or extra-regional lymph node involvement. 2. Non-right-dominant PHC (e.g., left-dominant or Bismuth type I, II, III tumors). 3. Cases where negative bile duct margins could be secured with conventional right trisectionectomy without Rex shunt. 4. Inadequate liver function or reserve (FLR <35%, ICG-Krem <0.05). 5. Poor overall performance status or comorbidities precluding major hepatectomy.

Design outcomes

Primary

Measure	Time frame
R0 resection	—

Secondary

Measure	Time frame
Intraoperative outcomes, postoperative complications, prognosis	—

Contacts

Public ContactYusuke Takemura

Department of Surgery, Keio University School of Medicine

yusuketkmr@gmail.com+81-3-3353-1211

Outcome results

None listed

Source: JPRN (via WHO ICTRP) · Data processed: Jul 3, 2026