Clinical significance of reconstruction of the right hepatic artery for biliary malignancy

Yoshihiro Sakamoto, Tsuyoshi Sano, Kazuaki Shimada, Tomoo Kosuge, Yoshihiro Kimata, Minoru Sakuraba, Junji Yamamoto, Hidenori Ojima

研究成果: Article査読

60 被引用数 (Scopus)

抄録

Background and aims: The clinical significance of resectional surgery with reconstruction of the right hepatic artery for biliary malignancy remains unclear. Patients/methods: Between 1990 and 2004, six patients (5%) with cholangiocarcinoma and five patients (3%) with gallbladder carcinoma with possible involvement of the right hepatic artery underwent resectional surgery with reconstruction of the right-sided hepatic artery. The surgical procedures included extended left hemihepatectomy (n=4), left trisectionectomy (n=1), central bisegmentectomy (n=1), resection of anterior segment and inferior area of segment 4 (n=2), resection of segment 5 and inferior area of segment 4 (n=1), and extrahepatic bile duct resection (n=2). Segmental resection and reconstruction of the right (n=7), anterior (n=1), or posterior (n=3) hepatic artery was performed by end-to-end anastomosis (n=5), using the right gastroepiploic artery (n=4), the gastroduodenal artery (n=1), or an autologous venous graft (n=1). Results: There was no in-hospital mortality. Histopathological arterial involvement was present in seven patients, and the surgical margin was positive in five patients. The median survival was 23 months in R0 patients (n=6), while it was 13 months in R1 patients (n=5) (p=0.16). Conclusion: Reconstruction of the right hepatic artery was safely performed in patients with biliary malignancy. Arterial reconstruction can be indicated when the arterial involvement is the only obstacle to obtain negative surgical margins.

本文言語English
ページ(範囲)203-208
ページ数6
ジャーナルLangenbeck's Archives of Surgery
391
3
DOI
出版ステータスPublished - 2006 6月
外部発表はい

ASJC Scopus subject areas

  • 外科

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