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01-07-2018 | Original Article

Hepatic Artery Resection for Bismuth Type III and IV Hilar Cholangiocarcinoma: Is Reconstruction Always Required?

Authors: Hai-Jie Hu, Yan-Wen Jin, Rong-Xing Zhou, Anuj Shrestha, Wen-Jie Ma, Qin Yang, Jun-Ke Wang, Fei Liu, Nan-Sheng Cheng, Fu-Yu Li

Published in: Journal of Gastrointestinal Surgery | Issue 7/2018

Abstract

Objective

The objective of the study is to examine the feasibility of hepatic artery resection (HAR) without subsequent reconstruction (RCS) in specified patients of Bismuth type III and IV hilar cholangiocarcinoma.

Methods

We retrospectively reviewed 63 patients who underwent hepatic artery resection for Bismuth type III and IV hilar cholangiocarcinoma. These patients were subsequently enrolled into two groups based on whether the artery reconstruction was conducted. Postoperative morbidity and mortality, and long-term survival outcome were compared between the two groups.

Results

There were 29 patients in HAR group and 34 patients in the HAR + RCS group. Patients with hepatic artery reconstruction tended to have longer operative time (545.6 ± 143.1 min vs. 656.3 ± 192.8 min; P = 0.013) and smaller tumor size (3.0 ± 1.1 cm vs. 2.5 ± 0.9 cm; P = 0.036). The R0 resection margin was comparable between the HAR group and HAR + RCS group (86.2 vs. 85.3%; P > 0.05). Twelve patients (41.4%) with 24 complications in HAR group and 13 patients (38.2%) with 25 complications in HAR + RCS group were recorded (P = 0.799). The postoperative hepatic failure rate (13.8 vs. 5.9%) and postoperative mortality rate (3.4% vs. 2.9%) were also comparable between the two groups. In the HAR group, the overall 1-, 3-, and 5-year survival rates were 72, 41, and 19%, respectively; while in the HAR + RCS group, the overall 1-, 3-, and 5-year survival rates were 79, 45, and 25%, respectively (P = 0.928).

Conclusions

Hepatic artery resection without reconstruction is also a safe and feasible surgical procedure for highly selected cases of Bismuth type III and IV hilar cholangiocarcinoma.

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Title: Hepatic Artery Resection for Bismuth Type III and IV Hilar Cholangiocarcinoma: Is Reconstruction Always Required?
Authors: Hai-Jie Hu
Yan-Wen Jin
Rong-Xing Zhou
Anuj Shrestha
Wen-Jie Ma
Qin Yang
Jun-Ke Wang
Fei Liu
Nan-Sheng Cheng
Fu-Yu Li
Publication date: 01-07-2018
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 7/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-3711-3

ACC 2024 Congress

Springer Medicine

Hepatic Artery Resection for Bismuth Type III and IV Hilar Cholangiocarcinoma: Is Reconstruction Always Required?

Abstract

Objective

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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