INTRODUCTION: Because surgical resection with simultaneous hepatic artery (HA) resection and reconstruction for perihilar cholangiocarcinoma (PHC) is technically demanding, the surgical indication for this challenging procedure is controversial. Thus, this study aimed to evaluate the efficacy of simultaneous HA resection and reconstruction for PHC. METHODS: Between January 2002 and January 2018, 13 patients with PHC underwent surgical intervention with simultaneous resection and reconstruction of the HA at Yamaguchi University Hospital (Ube, Japan) and Osaka University Hospital (Suita, Japan). RESULTS: There were 2 cases (15.4%) of 90-day postoperative mortality. Nine patients (69.2%) developed major postoperative complications (Clavien-Dindo classification ≥IIIa). Curative resections (R0) were achieved in 8 cases (61.5%). The median survival time (MST) and 1- and 3-year survival rates after resection (including in-hospital deaths) were 20.9 months and 61.5 and 10.3%, respectively. The MST and 1- and 2-year survival rates of 8 patients who underwent R0 resection were significantly better than those of the other 5 patients (24.2 vs. 10.2 months, 75.0 vs. 40.0%, and 50.0 vs. 0.0%, respectively, p = 0.0228). CONCLUSIONS: Simultaneous HA resection and reconstruction is technically possible and may provide long-term survival in selected patients with locally advanced PHC.
INTRODUCTION: Because surgical resection with simultaneous hepatic artery (HA) resection and reconstruction for perihilar cholangiocarcinoma (PHC) is technically demanding, the surgical indication for this challenging procedure is controversial. Thus, this study aimed to evaluate the efficacy of simultaneous HA resection and reconstruction for PHC. METHODS: Between January 2002 and January 2018, 13 patients with PHC underwent surgical intervention with simultaneous resection and reconstruction of the HA at Yamaguchi University Hospital (Ube, Japan) and Osaka University Hospital (Suita, Japan). RESULTS: There were 2 cases (15.4%) of 90-day postoperative mortality. Nine patients (69.2%) developed major postoperative complications (Clavien-Dindo classification ≥IIIa). Curative resections (R0) were achieved in 8 cases (61.5%). The median survival time (MST) and 1- and 3-year survival rates after resection (including in-hospital deaths) were 20.9 months and 61.5 and 10.3%, respectively. The MST and 1- and 2-year survival rates of 8 patients who underwent R0 resection were significantly better than those of the other 5 patients (24.2 vs. 10.2 months, 75.0 vs. 40.0%, and 50.0 vs. 0.0%, respectively, p = 0.0228). CONCLUSIONS: Simultaneous HA resection and reconstruction is technically possible and may provide long-term survival in selected patients with locally advanced PHC.
Authors: T Ebata; S Hirano; M Konishi; K Uesaka; Y Tsuchiya; M Ohtsuka; Y Kaneoka; M Yamamoto; Y Ambo; Y Shimizu; F Ozawa; A Fukutomi; M Ando; Y Nimura; M Nagino Journal: Br J Surg Date: 2018-02 Impact factor: 6.939
Authors: John N Primrose; Richard P Fox; Daniel H Palmer; Hassan Z Malik; Raj Prasad; Darius Mirza; Alan Anthony; Pippa Corrie; Stephen Falk; Meg Finch-Jones; Harpreet Wasan; Paul Ross; Lucy Wall; Jonathan Wadsley; Jeff T R Evans; Deborah Stocken; Raaj Praseedom; Yuk Ting Ma; Brian Davidson; John P Neoptolemos; Tim Iveson; James Raftery; Shihua Zhu; David Cunningham; O James Garden; Clive Stubbs; Juan W Valle; John Bridgewater Journal: Lancet Oncol Date: 2019-03-25 Impact factor: 41.316
Authors: S Kobayashi; A Tomokuni; K Gotoh; H Takahashi; H Akita; S Marubashi; T Yamada; T Teshima; K Fukui; Y Fujiwara; M Sakon Journal: Eur J Surg Oncol Date: 2017-01-11 Impact factor: 4.424
Authors: Tomoki Ebata; Giorgio Ercolani; Domenico Alvaro; Dario Ribero; Luca Di Tommaso; Juan W Valle Journal: Liver Cancer Date: 2016-11-29 Impact factor: 11.740
Authors: F Rassam; E Roos; K P van Lienden; J E van Hooft; H J Klümpen; G van Tienhoven; R J Bennink; M R Engelbrecht; A Schoorlemmer; U H W Beuers; J Verheij; M G Besselink; O R Busch; T M van Gulik Journal: Langenbecks Arch Surg Date: 2018-01-19 Impact factor: 3.445