Analysis of the therapeutic effect of vascular resection and reconstruction during radical resection of hilar cholangiocarcinoma
10.3760/cma.j.cn113884-20250805-00255
- VernacularTitle:肝门部胆管癌根治术中血管切除重建的疗效分析
- Author:
Lei LIU
1
;
Wenjun ZHANG
;
Jian WANG
;
Qi WANG
;
Yin YIN
;
Yang SUN
;
Fangzhao BU
;
Qingxiang XU
Author Information
1. 安徽医科大学第一附属医院普外科肝胆胰外科 肿瘤免疫微环境研究及治疗安徽省重点实验室，合肥 230000
- Publication Type:Journal Article
- Keywords:
Postoperative complications;
Prognosis;
Hilar cholangiocarcinoma;
Vascular reconstruction
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(11):827-831
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical efficacy of vascular resection and reconstruction during radical resection in patients with hilar cholangiocarcinoma.Methods:A retrospective analysis was conducted on the clinical data of 151 patients with hilar cholangiocarcinoma who underwent radical resection in the Department of Hepatobiliary and Pancreatic Surgery at the First Affiliated Hospital of Anhui Medical University from April 2018 to April 2025. Among them, there were 91 males and 60 females, with an age of (65.4±10.5) years. According to whether radical resection of hilar cholangiocarcinoma was combined with vascular resection, the patients were divided into the vascular resection group ( n=19) and the control group ( n=132). Postoperative complications such as bleeding, biliary fistula, and thrombosis were recorded, along with intraoperative blood loss, R 0 resection rate, perioperative mortality, and recurrence rate at six months postoperatively. Results:The preoperative bilirubin reduction and intraoperative blood loss in the vascular resection group were 6 (31.6) and 200 (200, 200) ml, respectively, while those in the control group were 45 (34.1) and 200 (100, 200) ml, respectively. There were no statistically significant differences between the two groups (all P>0.05). The combined liver resection, Billroth operation type Ⅰ-Ⅱ, and operation time in the vascular resection group were 18 (94.7), 1 (5.3), and 420 (377.5, 512.5) min, respectively, while those in the control group were 79 (59.8), 38 (28.8), and 322.5 (260, 410) min, respectively. There were statistically significant differences between the two groups (all P<0.05). The R 0 resection, perioperative mortality rate, postoperative bleeding, postoperative biliary fistula, postoperative thrombosis, postoperative pathology (adenocarcinoma), and recurrence rate at 6 months after surgery in the vascular resection group were 16 (84.2), 2 (10.5), 2 (10.5), 3 (15.8), 1 (5.3), 18 (94.7), and 1 (5.9), respectively, while those in the control group were 103 (78.0), 5 (3.8), 5 (3.8), 25 (18.9), 2 (1.5), 121 (91.7), and 6 (4.7), respectively. There were no statistically significant differences between the two groups (all P>0.05). The postoperative hospital stay, alanine aminotransferase on the 1st and 3rd day after surgery, and postoperative liver failure in the vascular resection group were 18 (13.5, 21.5) days, 619 (305.4, 1 634.0) U/L, and 1 (5.3), respectively, while those in the control group were 14 (11, 18), 254.5 (139.3, 468.3) U/L, and 3 (2.3), respectively. There were statistically significant differences between the two groups (all P<0.05). Conclusion:Vascular resection and reconstruction during radical resection of hilar cholangiocarcinoma in patients has certain safety and efficacy.
