Associating liver partition and portal vein ligation for staged hepatectomy combined with hepatic artery reconstruction in the treatment of hilar cholangiocarcinoma
10.3760/cma.j.issn.1007-8118.2018.09.006
- VernacularTitle:联合肝脏离断和门静脉结扎的二步肝切除技术并肝动脉重建治疗肝门部胆管癌
- Author:
Yaoxuan WANG
1
;
Ke LI
;
Yuwei TIAN
;
Qingfeng JIANG
;
Quan SHEN
;
Jiangkun JIA
;
Huanzhou XUE
Author Information
1. 河南省人民医院肝胆外科
- Keywords:
Hilar cholangiocarcinoma;
Hepatic artery reconstruction;
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)
- From:
Chinese Journal of Hepatobiliary Surgery
2018;24(9):600-603
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the combined use of ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) with hepatic artery reconstruction in the treatment of hilar cholangiocarcinoma with hepatic arterial involvement.Methods The clinical data of 7 patients with hilar cholangiocarcinoma who underwent ALPPS combined with hepatic arterial resection and reconstruction were analyzed retrospectively.The technical points and the perioperative management were analyzed.Methods At the first stage,the relationship between the tumor and the vessels were explored,the portal vein of the part of the liver to be resected was ligated and the liver was transected with a CUSA (Cavitron Ultrasound Surgical Aspirator).Then the bile duct was cut and a hepaticojejunostomy was completed.Finally,under ultrasound guidance,a bile duct drainage tube was inserted transhepatically into the part of the liver which was to be resected.Two to three weeks later,and after enough hypertrophy of the liver remnant size was confirmed,tumor resection was completed with reconstruction of the hepatic artery.Results Seven patients underwent the second stage operation,with no perioperative death.Six patients developed pulmonary infection and were treated successfully with conservative treatment.Two patients developed postoperative bile leak with secondary abdominal infection.One patient developed postoperative hepatic artery thrombosis secondary to biliary tract infection.Conclusion ALPPS combined with hepatic artery reconstruction was safe and feasible in the treatment of hilar cholangiocarcinoma with hepatic arterial involvement.
