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Effect of hepatic artery resection and reconstruction on the prognosis of patients with advanced hilar cholangiocarcinoma

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World Journal of Gastrointestinal Oncology 2022年第4期14卷 887-896页

作者： Yuan-Ming Li Zhi-Xin Bie Run-Qi Guo Bin Li Cheng-En Wang Fei Yan Minimally Invasive Tumor Therapies Center Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical SciencesBeijing 100730China

BACKGROUND Hilar cholangiocarcinoma(HC)is a good adaptation certificate of hepatic arterectomy,and hepatic arterectomy is conductive to the radical resection of cholangiocarcinoma,which simplifies the operation and helps with a combined resection of the peripheral portal *** continuous development of surgical techniques,especially microsurgical technique,vascular invasion is no longer a contraindication to surgery in the past 10 ***,hepatic artery reconstruction after hepatic arterectomy has been performed to treat liver tumor in many centers with better results,but it is rarely applied in advanced *** To determine the prognosis of patients with advanced HC after hepatic artery resection and *** A total of 98 patients with HC who underwent radical operation in our hospital were selected for this retrospective *** to whether the patients underwent hepatic artery resection and reconstruction or not,they were divided into reconstruction(n=40)and control(n=58)*** traumatic indices,surgical resection margin,liver function tests before and after the operation,and surgical complications were compared between the two *** Operation time,blood loss,hospital stay,and gastrointestinal function recovery time were higher in the reconstruction group than in the control group(Presection rates were 90.00%and 72.41%in the reconstruction and control groups,respectively(P0.05),but was higher in the reconstruction group(P0.05).Two-year survival rate(42.50%vs 39.66%)and two-year survival time(22.0 mo vs 23.0 m

关键词： Advanced stage Hilar cholangiocarcinoma hepatic artery resection Reconstruction Radical surgery

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Combined vascular resection and analysis of prognostic factors for hilar cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2015年第6期14卷 626-632页

作者： Shu-Tong Wang Shun-Li Shen Bao-Gang Peng Yun-Peng Hua Bin Chen Ming Kuang Shao-Qiang Li Qiang He Li-Jian Liang Department of hepatic Surgery First Affiliated HospitalSun Yat-Sen University

BACKGROUND： Hilar cholangiocarcinoma （HCCA） is a devastating malignancy arising from the bifurcation of the hepatic duct, whether combined vascular resection benefits HCCA patients is controversial. This study was undertaken to assess the effect of combined vascular resection in HCCA patients and to analyze the prognostic factors.

关键词： hilar cholangiocarcinoma hepatic artery resection portal vein resection prognostic factors

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Assessment of clinical outcomes of advanced hilar cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2018年第2期17卷 155-162页

作者： Kang-Jie Chen Fu-Chun Yang Yun-Sheng Qin Jing Jin Shu-Sen Zheng Division of Hepatobiliary Pancreatic Surgery First Affiliated Hospital Zhejiang University School of Medicine

Background: Low resectability and poor survival outcome are common for hilar cholangiocarcinoma(HCCA), especially in advanced stages. The present study was to assess the clinical outcome of advanced HCCA, focusing on therapeutic modalities, survival analysis and prognostic ***: Clinical data of 176 advanced HCCA patients who had been treated in our hospital between January 2013 and December 2015 were analyzed retrospectively. Prognostic effects of clinicopathological factors were explored by univariate and multivariate analysis. Survival predictors were evaluated by the receiver operating characteristic(ROC) ***: The 3-year overall survival rate was 13% for patients with advanced HCCA. Preoperative total bilirubin(P = 0.009), hepatic artery invasion(P = 0.014) and treatment modalities(P = 0.020) were independent prognostic factors on overall survival. A model combining these independent prognostic factors(area under ROC curve: 0.748; 95% CI: 0.678–0.811; sensitivity: 82.3%, specificity: 53.5%) was highly predictive of tumor death. After R0 resection, the 3-year overall survival was up to 38%. Preoperative total bilirubin was still an independent negative factor, but not for hepatic artery ***: Surgery is still the best treatment for advanced HCCA. Preoperative biliary drainage should be performed in highly-jaundiced patients to improve survival. Prediction of survival is improved significantly by a model that incorporates preoperative total bilirubin, hepatic artery invasion and treatment modalities.

关键词： Hilar cholangiocarcinoma hepatic artery resection Preoperative biliary drainage Prognostic factors

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