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01-06-2006 | Original Article

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

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

Published in: Langenbeck's Archives of Surgery | Issue 3/2006

Abstract

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.

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Title: Clinical significance of reconstruction of the right hepatic artery for biliary malignancy
Authors: Yoshihiro Sakamoto
Tsuyoshi Sano
Kazuaki Shimada
Tomoo Kosuge
Yoshihiro Kimata
Minoru Sakuraba
Junji Yamamoto
Hidenori Ojima
Publication date: 01-06-2006
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 3/2006
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-006-0026-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background and aims

Patients/methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and aims

Patients/methods

Results

Conclusion

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