Background : Intrahepatic cholangiocarcinoma is one of the common hepatic malignancies in Thailand. Clinical presentations are abdominal pain, palpable mass, weight loss, anemia, and jaundice. Distant metastasis affects poor survival outcomes. R0 resection with lymphadenectomy is standard of care and increases survival. Radical resection increases R0 resection rate, but recurrence rates are high.

Methods : A Thai female presents with chronic abdominal pain for 1 month with significant weight loss. Abdominal Computerized Tomography demonstrated an intrahepatic nonarterial enhancing lesion at the right lobe liver with subcapsular retraction with directed invasion to the right kidney. The patient was performed right hepatectomy with right nephrectomy with anterior approach technique.

Results : The patients was performed mirror L incision. Operative time was 4 hours and 30 minutes. Intraoperative blood loss 200 ml without any intraoperative complication. The patient was discharged on day 5 with uneventful. After 1 month of operation, the patient had received systemic chemotherapy. Postoperative follow-up period at 3 months, there is no recurrence tumor or metastasis.

Conclusions : Radical Right hepatectomy with right nephrectomy can increase the R0 resection rate and may have survival benefit