To summarize our experience of laparoscopic left-liver-first anterior radical modular orthotopic right hemihepatectomy for Bismuth Ⅲa hilar cholangiocarcinoma(Lap-Larmorh).

The researchers recorded and analyzed the clinical data of patients undergoing this novel procedure at the Second Hospital of Hebei Medical University in Jun.2020.

The operation has been successfully performed. The operative time was 390 min, and the estimated blood loss was 600 ml. The blood transfusion occurred, and 0.5 U red blood cells and 600 ml plasma were required. The patient recovered well after surgery and did not have postoperative complications such as bleeding, bile leakage, gastrointestinal leakage, and biliary stricture. The pathological results confirmed the diagnosis of Bismuth Ⅲa hilar cholangiocarcinoma.

It is safe and feasible to perform Lap-Larmorh for Bismuth Ⅲa hilar cholangiocarcinoma. This novel procedure avoids traction and compression of the tumor and complies with the "no-touch" and "en-block" basic oncological principles. Compared to conventional right liver resection, Lap-Larmorh also has an extended operative space when dealing with the short hepatic vein and right hepatic vein by the assistant pulling the left liver to the patient′s left.