Hepatic artery reconstruction after hilar cholangiocarcinoma resection / 中华普通外科杂志

ABSTRACT

Objective To summarize the clinical experience of hepatectomy with hepatic artery resection and reconstruction using gastroduodenal artery during radical resection of hilar cholangiocarcinoma.Methods From Dec.2004 to Dec.2008,nine cases of hilar cholangiocarcinoma with hepatic artery invasion were subjected to radical resection comhined with tumor invaded hepatic artery resection and reconstruction using gastroduodenal artery.The clinical data of these patients were reviewed.Results Nine cases underwent hilar cholangiocarcinoma radical resection with hepatic artery resection,immediate hepatic artery reconstruction using gastroduodenal artery end to end anastomosis while hepatic artery resection exceeding 1 cm.One patient underwent partial resection of the portal vein and repair using autogenous segment of great saphenous vein.Roux-en-Y hepaticojejunostomy was performed in 9 patients with intrahepatic bile duct stents in 8 patients.All patients suffered from postoperative transient SIRS and recovered within 2-3 days after operation.One patient experienced massive bleeding from the upper alimentary tract 3 day after operation and the bleeding was controlled afterwards.The blood flow in the reconstructed hepatic arteries monitored by Doppler was normal two weeks after operation.There was no inhospital mortality.9 patients were followed up for 1-4 years,the median survival time is 23 months (6 months to 32 months).Conclusion Hepatic artery can be reconstructed using gastroduodenal artery during a radical resection of hilar cholangiocarcinoma,and hepatic artery reconstruction decreases the postoperative complications.