Introduction: Because surgical resection with simultaneous hepatic artery (HA) resection and reconstruction for perihilar cholangiocarcinoma (PHC) is technically demanding, the surgical indication for this challenging procedure is controversial. Thus, this study aimed to evaluate the efficacy of simultaneous HA resection and reconstruction for PHC. Methods: Between January 2002 and January 2018, 13 patients with PHC underwent surgical intervention with simultaneous resection and reconstruction of the HA at Yamaguchi University Hospital (Ube, Japan) and Osaka University Hospital (Suita, Japan). Results: There were 2 cases (15.4%) of 90-day postoperative mortality. Nine patients (69.2%) developed major postoperative complications (Clavien-Dindo classification ≥IIIa). Curative resections (R0) were achieved in 8 cases (61.5%). The median survival time (MST) and 1- and 3-year survival rates after resection (including in-hospital deaths) were 20.9 months and 61.5 and 10.3%, respectively. The MST and 1- and 2-year survival rates of 8 patients who underwent R0 resection were significantly better than those of the other 5 patients (24.2 vs. 10.2 months, 75.0 vs. 40.0%, and 50.0 vs. 0.0%, respectively, p = 0.0228). Conclusions: Simultaneous HA resection and reconstruction is technically possible and may provide long-term survival in selected patients with locally advanced PHC.
Gastrointest Tumors

中文翻译：

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肝门周围胆管癌同时切除和重建肝动脉的短期和长期结果

简介：由于肝门周围胆管癌 (PHC) 的手术切除与肝动脉 (HA) 切除和重建的同时技术要求很高，因此这一具有挑战性的手术的手术适应症存在争议。因此，本研究旨在评估同时 HA 切除和重建对 PHC 的疗效。方法： 2002 年 1 月至 2018 年 1 月期间，13 名 PHC 患者在山口大学医院（日本宇部）和大阪大学医院（日本吹田）接受了手术干预，同时切除和重建 HA。结果：术后90天死亡2例（15.4%）。9 名患者 (69.2%) 出现了严重的术后并发症（Clavien-Dindo 分级≥IIIa）。8例（61.5%）实现了根治性切除（R0）。切除后的中位生存时间 (MST) 和 1 年和 3 年生存率（包括院内死亡）分别为 20.9 个月和 61.5% 和 10.3%。接受 R0 切除的 8 例患者的 MST 和 1 年和 2 年生存率明显优于其他 5 例患者（分别为 24.2 个月对 10.2 个月、75.0 个月对 40.0% 和 50.0 对 0.0%，p = 0.0228）。结论：同时 HA 切除和重建在技术上是可行的，并且可以为选定的局部晚期 PHC 患者提供长期生存。
胃肠肿瘤