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.
| Original language | English |
|---|---|
| Pages (from-to) | 203-208 |
| Number of pages | 6 |
| Journal | Langenbeck's Archives of Surgery |
| Volume | 391 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jun 2006 |
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Keywords
- Arterial involvement
- Biliary malignancy
- Hepatic artery reconstruction
- Right gastroepiploic artery
- Surgical margins
ASJC Scopus subject areas
- Surgery
Cite this
Clinical significance of reconstruction of the right hepatic artery for biliary malignancy. / Sakamoto, Yoshihiro; Sano, Tsuyoshi; Shimada, Kazuaki; Kosuge, Tomoo; Kimata, Yoshihiro; Sakuraba, Minoru; Yamamoto, Junji; Ojima, Hidenori.
In: Langenbeck's Archives of Surgery, Vol. 391, No. 3, 06.2006, p. 203-208.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical significance of reconstruction of the right hepatic artery for biliary malignancy
AU - Sakamoto, Yoshihiro
AU - Sano, Tsuyoshi
AU - Shimada, Kazuaki
AU - Kosuge, Tomoo
AU - Kimata, Yoshihiro
AU - Sakuraba, Minoru
AU - Yamamoto, Junji
AU - Ojima, Hidenori
PY - 2006/6
Y1 - 2006/6
N2 - 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.
AB - 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.
KW - Arterial involvement
KW - Biliary malignancy
KW - Hepatic artery reconstruction
KW - Right gastroepiploic artery
KW - Surgical margins
UR - http://www.scopus.com/inward/record.url?scp=33744810343&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33744810343&partnerID=8YFLogxK
U2 - 10.1007/s00423-006-0026-8
DO - 10.1007/s00423-006-0026-8
M3 - Article
C2 - 16525853
AN - SCOPUS:33744810343
VL - 391
SP - 203
EP - 208
JO - Langenbeck's Archives of Surgery
JF - Langenbeck's Archives of Surgery
SN - 1435-2443
IS - 3
ER -