Therapeutic effect of hepatic artery and portal vein resection and reconstruction in the radical operation of hilar cholangiocarcinoma

doi:10.3877/cma.j.issn.1674-3946.2021.04.029

Abstract

Abstract:

Objective

To investigate the significance of hepatic artery and portal vein resection and reconstruction in the radical operation of hilar cholangiocarcinoma (HC).

Method

A retrospective analysis of the clinical data of 183 patients who underwent surgical treatment from January 2011 to July 2019, were performed. Patients were divided into the following three groups according to the surgical procedure: Group A (78 cases, palliative surgery); Group B (56 cases, portal vein reconstruction); Group C (49 cases, hepatic artery reconstruction). The data was analyzed by using SPSS22.0 statistical software. The incidence of postoperative complications in the three groups was examined by using χ² test. Kaplan-Meier method was used for postoperative survival analysis. A P value of <0.05 was considered as statistically significant difference.

Result

The incidence of complications in the palliative surgery group, portal vein reconstruction group, and hepatic artery reconstruction group were 73.1%, 66.1%, and 71.4% respectively, (P>0.05). In comparison of the 90-day mortality rate, the three groups were 10.3%, 3.6%, and 6.1% respectively(P>0.05).

Conclusion

Portal vein reconstruction and hepatic artery reconstruction are better than the palliative surgery group in terms of complications and mortality.

Key words: Bile duct neoplasms, Hepatic artery, Portal vein, Comparative effectiveness research

Ping He, Bo Zhang, Ke Dong, Jinhui Luo, Gang Li, Bo Liu. Therapeutic effect of hepatic artery and portal vein resection and reconstruction in the radical operation of hilar cholangiocarcinoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(04): 457-459.

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https://zhpwkssxzz.cma-cmc.com.cn/EN/Y2021/V15/I04/457

Figures/Tables 2

References 14

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组别	例	性别	年龄(岁)	CA19-9(U/ml)	直接胆红素(μmol/L)
组别	例	男/女	年龄(岁)	CA19-9(U/ml)	直接胆红素(μmol/L)
A组	78	56/22	68.7±3.2	54.3±6.3	214.4±8.3
B组	56	41/15	69.6±6.3	56.5±4.4	223.6±7.6
C组	49	30/19	72.3±4.3	55.6±4.8	235.5±8.7
F/χ²		0.332	0.187	0.147	0.654
P值		0.648	0.926	0.869	0.132

组别	例	性别	年龄(岁)	CA19-9(U/ml)	直接胆红素(μmol/L)
组别	例	男/女	年龄(岁)	CA19-9(U/ml)	直接胆红素(μmol/L)
A组	78	56/22	68.7±3.2	54.3±6.3	214.4±8.3
B组	56	41/15	69.6±6.3	56.5±4.4	223.6±7.6
C组	49	30/19	72.3±4.3	55.6±4.8	235.5±8.7
F/χ²		0.332	0.187	0.147	0.654
P值		0.648	0.926	0.869	0.132

组别	例数	高胆红素血症	肝功能衰竭	腹腔内脓肿	胰腺瘘	肝脏空肠吻合不足	腹壁裂开	伤口感染	肾功能衰竭	胃排空延迟	肺血栓形成	胆漏	发生率(%)
A组	78	4(5.1)	8(10.3)	10(12.8)	6(7.7)	7(9.0)	4(5.1)	2(2.6)	3(3.8)	5(6.4)	1(1.3)	7(9.0)	73.1
B组	56	5(8.9)	4(7.1)	9(16.1)	2(3.6)	3(5.4)	0(0.0)	3(5.4)	2(3.6)	1(1.8)	0(0.0)	8(14.3)	66.1
C组	49	4(8.2)	5(10.2)	8(16.3)	1(2.0)	5(10.2)	0(0.0)	2(4.1)	0(0.0)	1(2.0)	0(0.0)	9(18.4)	71.4
χ²													0.457
P值													0.532

组别	例数	高胆红素血症	肝功能衰竭	腹腔内脓肿	胰腺瘘	肝脏空肠吻合不足	腹壁裂开	伤口感染	肾功能衰竭	胃排空延迟	肺血栓形成	胆漏	发生率(%)
A组	78	4(5.1)	8(10.3)	10(12.8)	6(7.7)	7(9.0)	4(5.1)	2(2.6)	3(3.8)	5(6.4)	1(1.3)	7(9.0)	73.1
B组	56	5(8.9)	4(7.1)	9(16.1)	2(3.6)	3(5.4)	0(0.0)	3(5.4)	2(3.6)	1(1.8)	0(0.0)	8(14.3)	66.1
C组	49	4(8.2)	5(10.2)	8(16.3)	1(2.0)	5(10.2)	0(0.0)	2(4.1)	0(0.0)	1(2.0)	0(0.0)	9(18.4)	71.4
χ²													0.457
P值													0.532

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