Busan Centum General Hospital Successfully Performs Highly Complex Type IV Hilar Cholangiocarcinoma Surgery

Professor Park Kwangmin's Hepatobiliary and Pancreatic Surgery Team Achieves Complete Resection After 4-Hour Struggle
Medical Staff, Infrastructure, Treatment Capability, Equipment, and Facilities at University Hospital Level

Busan Centum General Hospital has drawn attention by successfully performing surgery for Type 4 perihilar cholangiocarcinoma, the most challenging form among perihilar bile duct cancers.

Kwangmin Park, Director of Hepatobiliary and Pancreatic Surgery.

This cancer is a malignant tumor that develops at the hepatic hilum, the area where the liver and bile ducts meet within the human body. It is one of the most fatal cancers and is classified into four types depending on the tumor's location and extent of spread.

Centum Medical Foundation Centum General Hospital (Chairman Park Jongho, Director Park Namcheol) announced that the team led by Dr. Park Kwangmin, Chief of Hepatobiliary and Pancreatic Surgery (former Professor of Hepatobiliary and Pancreatic Surgery at Asan Medical Center, Seoul), has successfully performed a complete resection of a Type 4 perihilar cholangiocarcinoma in patient A (female, 62 years old).

The ability to perform such a surgery is considered evidence that the hospital's medical staff, clinical capabilities, equipment, and facilities are at the level of a university hospital.

In perihilar cholangiocarcinoma, Type 1 refers to a tumor confined to the upper part of the main bile duct, while Type 2 involves tumor invasion up to the hepatic hilum. Type 3 is when the tumor has spread to either the left or right hepatic duct, and Type 4 refers to tumors that have spread from the hilum to both the left and right hepatic ducts.

Therefore, Type 4 is the most complex and difficult, requiring the highest level of surgical skill from experienced and highly trained specialists.

Hepatobiliary Graphic Material (Malignant Tumor Removal).

In the case of patient A, she was admitted to Centum General Hospital through outpatient care last month after experiencing symptoms such as generalized pruritus (itchiness), yellow urine, and jaundice. After an ultrasound examination at a local clinic, she was diagnosed with Type 4 perihilar cholangiocarcinoma.

At the time of admission, patient A's blood test showed a very high jaundice level of 9.8. Accordingly, left and right percutaneous biliary drainage was performed, significantly reducing the jaundice level to 2.9, after which surgery was performed on the 5th. The main reason for lowering the patient's jaundice level before surgery is to increase liver resilience, thereby improving surgical success rates and reducing complications.

The surgery involved Dr. Park Kwangmin and two other specialists, who, after more than four hours of intense effort, resected the patient's left liver and caudate lobe, and performed hepatic artery and portal vein reconstruction to completely remove the malignant tumor.

Dr. Park Kwangmin stated, "Surgery for Type 4 perihilar cholangiocarcinoma is extremely complex and difficult, but if complete resection is achieved, long-term survival can be expected. From diagnosis to treatment, advanced equipment and meticulous surgical technique are essential, and this serves as a key indicator of a medical institution's clinical level and capabilities. The ability to perform such surgery signifies university hospital-level competence."

The reason this surgery is considered the most challenging is primarily because major blood vessels and bile ducts are densely concentrated at the hepatic hilum. Extremely precise surgery is required to remove the tumor without damaging these structures.

In particular, Type 4 perihilar cholangiocarcinoma often involves tumors that are widely spread in the surrounding area, so extensive resection is necessary to accurately identify and completely remove them.

The hepatobiliary and pancreatic surgery team at Centum General Hospital, led by Dr. Park Kwangmin, a renowned former chief of hepatobiliary and pancreatic surgery at Asan Medical Center, Seoul, along with Dr. Lee Sangyeop and Dr. Noh Younghoon, and supported by excellent professional PA (physician assistant) nurses, performs surgeries through organic collaboration. As a result, they have continued to successfully perform high-difficulty surgeries, demonstrating capabilities comparable to those of university hospitals.