Application of perihilar surgical techniques in biliary tract surgery

Perihilar surgery is full of challenge, risk, variability and uncertainty. Because of the anatomic variability, the pathophysiological complexity and invasion of the diseases, hepatic hilar biliary surgery has the characteristics of high operative difficulties, low resection rate, easy intraoperative bleeding, more postoperative complications, high recurrence rate and mortality rate. The cure rate and safety of the operation can be improved only through comprehensive imaging examinations and preoperative evaluation of liver function as well as the correct use of surgical techniques of anatomic paths, lesions excision and hepatic hilar reconstruction. The core of perihilar surgical techniques is hepatic hilar anatomy and explosion, including hilar plate dissection, dissection of liver along the medial fissure, quadrate lobe of liver resection and perihilar resection. Perihilar surgery is a comprehensive technique involving preoperative, intraoperative and postoperative procedures. The cure rates of perihilar biliary diseases can be improved by a combination of enhanced recovery after surgery and optimized and individualized surgical plans for patients.