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2021 Volume 8
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RESEARCH ARTICLE   Open Access    

Short- and Long-Term Outcomes of Simultaneous Hepatic Artery Resection and Reconstruction for Perihilar Cholangiocarcinoma

  • a.

    Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan

  • b.

    Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

  • c.

    Department of Diagnostic Pathology, Yamaguchi University Hospital, Ube, Japan

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  • Corresponding author: Hiroaki Nagano Department of Gastroenterological, Breast and Endocrine Surgery Yamaguchi University Graduate School of Medicine 1-1-1 Minami-Kogushi, Ube 755-8505 (Japan) hnagano@yamaguchi-u.ac.jp
  • 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.

  • Cite this article

    Yoshitaro Shindo, Shogo Kobayashi, Hiroshi Wada, Yukio Tokumitsu, Satoshi Matsukuma, Hiroto Matsui, Masao Nakajima, Shin Yoshida, Michihisa Iida, Nobuaki Suzuki, Shigeru Takeda, Yoshinobu Hoshii, Hidetoshi Eguchi, Hiroaki Nagano. 2021. Short- and Long-Term Outcomes of Simultaneous Hepatic Artery Resection and Reconstruction for Perihilar Cholangiocarcinoma. Gastrointestinal Tumors. 8:511164 doi: 10.1159/000511164
    Yoshitaro Shindo, Shogo Kobayashi, Hiroshi Wada, Yukio Tokumitsu, Satoshi Matsukuma, Hiroto Matsui, Masao Nakajima, Shin Yoshida, Michihisa Iida, Nobuaki Suzuki, Shigeru Takeda, Yoshinobu Hoshii, Hidetoshi Eguchi, Hiroaki Nagano. 2021. Short- and Long-Term Outcomes of Simultaneous Hepatic Artery Resection and Reconstruction for Perihilar Cholangiocarcinoma. Gastrointestinal Tumors. 8:511164 doi: 10.1159/000511164
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Research Article   Open Access    

Short- and Long-Term Outcomes of Simultaneous Hepatic Artery Resection and Reconstruction for Perihilar Cholangiocarcinoma

  • a.

    Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan

  • b.

    Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

  • c.

    Department of Diagnostic Pathology, Yamaguchi University Hospital, Ube, Japan

  • Corresponding author: Hiroaki Nagano Department of Gastroenterological, Breast and Endocrine Surgery Yamaguchi University Graduate School of Medicine 1-1-1 Minami-Kogushi, Ube 755-8505 (Japan) hnagano@yamaguchi-u.ac.jp
  • Received: 10 July 2020
  • Accepted: 24 August 2020
  • Published online: 10 November 2020
Gastrointestinal Tumors  8,  Article number: 10.1159/000511164  (2021)  |  Cite this article

Abstract: 

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.

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    Cite this article
    Yoshitaro Shindo, Shogo Kobayashi, Hiroshi Wada, Yukio Tokumitsu, Satoshi Matsukuma, Hiroto Matsui, Masao Nakajima, Shin Yoshida, Michihisa Iida, Nobuaki Suzuki, Shigeru Takeda, Yoshinobu Hoshii, Hidetoshi Eguchi, Hiroaki Nagano. 2021. Short- and Long-Term Outcomes of Simultaneous Hepatic Artery Resection and Reconstruction for Perihilar Cholangiocarcinoma. Gastrointestinal Tumors. 8:511164 doi: 10.1159/000511164
    Yoshitaro Shindo, Shogo Kobayashi, Hiroshi Wada, Yukio Tokumitsu, Satoshi Matsukuma, Hiroto Matsui, Masao Nakajima, Shin Yoshida, Michihisa Iida, Nobuaki Suzuki, Shigeru Takeda, Yoshinobu Hoshii, Hidetoshi Eguchi, Hiroaki Nagano. 2021. Short- and Long-Term Outcomes of Simultaneous Hepatic Artery Resection and Reconstruction for Perihilar Cholangiocarcinoma. Gastrointestinal Tumors. 8:511164 doi: 10.1159/000511164
    shu

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