Planned hepatectomy for the "central type" intrahepatic and extrahepatic choledochal cysts
10.3760/cma.j.issn.1007-8118.2017.09.011
- VernacularTitle:计划性肝切除在“中央型”肝内外胆管囊肿治疗中的应用
- Author:
Bin LI
1
,
2
;
Zhiquan QIU
;
Chen LIU
;
Xiangji LUO
;
Qingbao CHENG
;
Feiling FENG
;
Chang XU
;
Yue WU
;
Baihe ZHANG
;
Xiaoqing JIANG
Author Information
1. 200438 上海,第二军医大学东方肝胆外科医院胆道外科
2. 第二军医大学胆道恶性肿瘤诊疗中心
- Keywords:
Intrahepatic and extrahepatic bile duct cysts;
Congenital cystic dilatation of bile duct;
Planned hepatectomy;
Percutaneous transhepatic cholangial drainage (PTCD);
Portal vein embolization (PVE)
- From:
Chinese Journal of Hepatobiliary Surgery
2017;23(9):619-623
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively study the clinical value and the advantages in " planned hepatectomy" for the "central type" intrahepatic and extrahepatic choledochal cysts.Methods The clinical data of 7 patients with the "central type" of intrahepatic and extrahepatic choledochal cysts which were treated with "planned hepatectomy" from January 2014 through April 2017 at the Department of Biliary Tract Surgery of the Eastern Hepatobiliary Surgery Hospital,Second Military Medical University were retrospectively analyzed.Results All the patients completed radical resection of the intrahepatic and extrahepatic choledochal cysts in accordance with the " planned hepatectomy".The operations included 6 patients who were treated with percutaneous transhepatic cholangial drainage (PTCD) and 5 patients with portal vein embolization (PVE) prior to the surgical excision.Combined right liver resection was performed in 6 patients,and combined left liver resection in one patient.All the 7 patients had a history of chronic cholangitis.Liver volume tests demonstrated that the hemiliver volume to be removed (the embolized hemiliver) significantly decreased after PVE,whereas the hemilivers to be persevered were remarkably enlarged.No complication associated with PTCD and PVE occurred.The mean postoperative hospitalization was 12 days.Liver function tests suggested all the patients recovered well.No postoperative complication of bleeding,infection or liver function failure was observed,except in one patient who experienced pleural and abdominal effusion.Conclusions Combined subtotal hepatectomy may increase the risk of complications associated with the "central type" intrahepatic and extrahepatic choledochal cysts.The surgical strategy in planned hepatectomy can be used effectively to treat the "central type" of intrahepatic and extrahepatic choledochal cysts,with improved surgical safety,decrease in incidences of postoperative liver function failure and residual choledochal cysts.
