Complex liver resection for a large intrahepatic cholangiocarcinoma in a Jehovah's witness: a strategy to avoid transfusion

J Surg Oncol. 2007 Sep 1;96(3):249-53. doi: 10.1002/jso.20799.


Although morbidity and mortality after liver resection have improved over the last two decades, complex liver resections still require perioperative blood transfusions. In this report, we describe the use of a combined left trisegmentectomy and caudate lobectomy, along with resection of the inferior vena cava, to treat a large intrahepatic cholangiocarcinoma in a Jehovah's Witness. To our knowledge, this is the first report of major liver resection for a large malignant tumor in this patient population. We also discuss the perioperative strategy and surgical technique we used to minimize blood loss and avoid transfusion. This approach could be a safe alternative for use in all patients with complex liver tumor, regardless of their religious beliefs, to reduce the risks and cost associated with blood transfusion.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / surgery
  • Bile Duct Neoplasms / surgery*
  • Bile Ducts, Intrahepatic / surgery*
  • Blood Loss, Surgical / prevention & control
  • Cholangiocarcinoma / surgery*
  • Digestive System Surgical Procedures / methods*
  • Female
  • Hemodilution
  • Humans
  • Jehovah's Witnesses*
  • Liver / surgery*
  • Liver Neoplasms / surgery
  • Middle Aged
  • Vena Cava, Inferior / surgery