The application of vascular resection in the radical resection of hilar cholangiocarcinoma:an analysis of 16 cases / 中国医师进修杂志

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 followsbile 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.