It is mandatory to examine the specimen in a fresh, unfixed state, in the operating theatre in close cooperation with the surgeons. The bile ducts should be probed and the site of origin of the carcinoma must be identified exactly. This is more important for carcinoma arising in the extra hepatic bile duct, in relation to the longitudinal extension of the neoplasia (Bismuth-Corlette Classification) . The tumour should then be recorded in relation to the main branches/trunk of the portal vein or hepatic artery, also using radiological data.
In case of suspected tumour adherence to the portal vein requiring vessel resection, the segment should be separated from the specimen, serially sectioned and submitted "in toto" so that tumour invasion can be checked histologically. Both ends and perivascular tissue have to be considered as additional resection margins.
Local tumour extension and invasion of adjacent structures should also be reported.
Was this article helpful?