目的：探讨肝门胆管癌根治切除联合左半肝及右前叶腹侧段切除的临床疗效。方法：回顾性分析2019年11月北京清华长庚医院1例肝门胆管癌病人行根治切除联合左半肝及右前叶腹侧段切除的临床资料,并复习相关肝脏右前叶解剖和手术的文献。结果：本病例为74岁女性病人,术前影像学诊断为Bismuth Ⅳ型肝门胆管癌,成功经历肝门胆管癌根治切除联合左半肝及右前叶腹侧段切除术,手术时间共11 h 23 min,术中出血300 mL。术后病情平稳,术后第17天出院。结论：肝门胆管癌根治切除联合左半肝及右前叶腹侧段切除与肝门胆管癌根治切除联合左三区切除手术方式相比,可在根治性切除目标病灶同时有效地保留更多功能性肝体积,避免术后肝衰竭的发生。

Objective To investigate the clinical result of radical resection of hilar cholangiocarcinoma combined with left hepatectomy and resection of ventral segment of right anterior sector. Methods The data of one patient diagnosed as hilar cholangiocarcinoma and treated with radical resection combined with left hepatectomy and resection of ventral segment of right anterior sector was analyzed in Beijing Tsinghua Changgung Hospital in November 2019, and the literatures associated with anatomy and surgery of right anterior sector of liver were reviewed. Results This was 74-year-old female diagnosed as Bismuth type Ⅳ hilar cholangiocarcinoma after preoperative image. She had radical resection successfully combined with left hepatectomy and resection of ventral segment of the right anterior sector. The operative time was 11 h 23 min with 300 mL intraoperative bleeding. The postoperative course was smooth and patient discharged on the 17th day after operation. Conclusions Compared with left trisectionectomy in the radical resection of hilar cholangiocarcinoma, left hepatectomy combined with resection of ventral segment of right anterior sector could preserve more functional liver vo-lume effectively while radical resection of the target lesion and avoidance of postoperative liver failure.