Modified Arterioportal Shunting in Radical Resection of Hilar Cholangiocarcinoma

作者:Chen, Yongliang*; Liu, Zhiwei; Duan, Weidong; Huang, Xiaoqiang; Lv, Wenping; Tong, Junxiang; Dong, Jiahong; Huang, Zhiqiang
来源:Hepato-Gastroenterology, 2014, 61(129): 9-11.
DOI:10.5754/hge12839

摘要

Background/Aims: The resection and reconstruction of hepatic artery is often required in radical surgery for hilar cholangiocarcinoma. In this study, we reported our experience in performing the arterioportal shunting with restriction of the arterial caliber as an alternative for the arterial reconstruction on the basis of our experiment when reconstruction of hepatic artery is impossible. Methodology: Eight patients with hilar cholangiocarcinoma underwent extended left hepatectomy and caudate lobectomy combined with en bloc resection of hepatic artery and arterioportal shunting with restriction of the arterial caliber. The efficacy of arterioportal shunting and restriction of the arterial caliber in preventing complications of arterioportal shunting were assessed by computed tomography angiography (CTA) perioperational period and 2 years follow-up after the operation. Results: Eight patients recovered uneventfully without any complication. CTA showed a patent shunt and normal liver regeneration. No signs of portal hypertension were found in two years of follow-up. Conclusions: Arterioportal shunting with restriction of the arterial caliber appears to be a feasible and safe alternative for the microvascular reconstruction after hepatic artery resection in radical surgery for hilar cholangiocarcinoma.

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