The application of vascular resection in the radical resection of hilar cholangiocarcinoma:an analysis of 16 cases
10.3760/cma.j.jssn.1673-4904.2016.07.016
- VernacularTitle:联合血管切除重建在肝门部胆管癌根治术中的应用（附16例病例分析）
- Author:
Weipeng QI
;
Jianming WANG
;
Jian ZHANG
;
Yan LIU
;
Junchuang HE
;
Yawei QIAN
;
Wei YAO
;
Wei FENG
- Publication Type:Journal Article
- Keywords:
Bile duct neoplasms;
Vascular surgical procedures;
Imaging,three-dimensional;
Porta hepatis
- From:
Chinese Journal of Postgraduates of Medicine
2016;39(7):627-630
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the role of vascular resection in the radical resection of hilar cholangiocarcinoma. Methods One hundred and forty-two cases of hilar cholangiocarcinoma (HC) data during July 2009 and December 2014 were analyzed retrospectively .After sufficient preoperative management including relieving jaundice , three dimensional assessments were evaluated and then surgical planning was designed. Results One hundred and forty-two cases underwent surgery after adequate preoperative preparation and evaluation, of whom 16 patients had vascular resection. Portal vein resection was performed in 11 cases, in which the portal vein wedge excision was performed in 4 cases, the portal vein anastomosis in 6 cases, and right anterior portal vein resection and reconstruction was performed in 1 case. Because of tumor invasion in the right hepatic artery, 4 patients underwent right hepatic artery resection and saphenous vein reconstruction, and 1 patient underwent right hepatic artery anastomosis. Postoperative complications were as follows:bile leakage in 1 case, no abdominal bleeding and abdominal infection, and no vascular thrombosis-related complications, and the overall complication rate was 1/16. There was no perioperative death . The follow-up results was as follows: 1 patient died 3 months after surgery, 1 died of liver metastasis after 9 months, 2 cases were lost to follow up, and the rest patients were still followed up. Conclusions Vascular resection for hilar cholangiocarcinoma helps to improve tumor resection rate and prognosis in large medical centers. With the use of three dimensional assessment, preoperative management and reasonable surgical strategy can reduce postoperative complications and ensure safety for hilar cholangiocarcinoma resection.
