Abstract:
Objective To summary the experiences in liver resection with artery resection in patients with progressive hilar cholangiocarcinoma.
Methods Clinical data about 15 patients with progressive hilar cholangiocarcinoma admitted to our hospital from January 2008 to December 2013 for liver resection with artery resection were retrospectively analyzed. Their outcomes after operation were summarized.
Results Of the 15 patients, 5 underwent end to end anastomosis of the right hepatic artery with the hepatic proper artery, 3 end to end anastomosis of the right hepatic artery with the gastroduodenal artery, 1 end to end anastomosis of the right hepatic artery with the left hepatic artery, 1 end to end anastomosis of the right hepatic artery with the right hepatic artery, 1 end to end anastomosis of the right posterior hepatic artery with the right posterior hepatic artery, 3 end to side anastomosis of the hepatic proper artery with the portal vein, 1 end to side anastomosis of the right hepatic artery with the portal vein, 4 combined portal vein resection and reconstruction. Of the 15 patients, 11 underwent radical resection and 4 received non-radical resection. Biliary fistula was found in 3 patients, biliary fistula with intra-abdominal infection in 1 patient, intra-abdominal infection in 1 patient, upper gastrointestinal hemorrhage in 1 patient. All patients were cured by conservative treatment except 2 died of liver failure after operation. Of the 4 patients with their tumor relapsed 6 -26 months (17.5 months) after operation, 1 (25%) underwent radical resection and 3 (75%) received non-radical resection. Their 6-month, 1-and 3-year survival rate was 85.6%, 78.6%, and 33.7%, respectively.
Conclusion Liver resection with artery resection in patients with hilar cholangiocarcinoma with their artery involved can improve their radical resection rate and prognosis. Skilled vascular anastomosis can greatly reduce the incidence of complications after operation.