Surgical innovation · 2013
Portal vein arterialization as a bridge procedure against acute liver failure after extended hepatectomy for hilar cholangiocarcinoma.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Qiu Jianguo, Chen Shuting, Pankaj Prasoon, Wu Hong
Аннотация
BACKGROUND: Acute liver failure (ALF) is a severe and highly fatal complication arising after extended hepatobiliary surgery. The aim of this study was to investigate the primary management experience of portal vein arterialization (PVA) as a bridge procedure to reduce the risk of ALF for hilar cholangiocarcinoma (HCCA) after extended hepatectomy.
METHOD: Between January 2010 and January 2012, 4 patients with HCCA with possible involvement of the right and/or left hepatic artery underwent resectional surgery with reconstruction of the right or left artery blood flow by arterializations of portal vein.
RESULTS: The arteries used for this surgical procedure included gastroduodenal artery (n = 2), common hepatic artery (n = 1), and right gastroepiploic artery (n = 1). PVA was verified as a key point during the course of the disorder between surgery and postoperative recovery. During follow-up, 1 patient suffered secondary portal hypertension and was subsequently cured by interventional artery coil embolization.
CONCLUSION: PVA can be indicated where there is arterial involvement in HCCA patients who have undergone extended hepatectomy or trisectionectomy.
METHOD: Between January 2010 and January 2012, 4 patients with HCCA with possible involvement of the right and/or left hepatic artery underwent resectional surgery with reconstruction of the right or left artery blood flow by arterializations of portal vein.
RESULTS: The arteries used for this surgical procedure included gastroduodenal artery (n = 2), common hepatic artery (n = 1), and right gastroepiploic artery (n = 1). PVA was verified as a key point during the course of the disorder between surgery and postoperative recovery. During follow-up, 1 patient suffered secondary portal hypertension and was subsequently cured by interventional artery coil embolization.
CONCLUSION: PVA can be indicated where there is arterial involvement in HCCA patients who have undergone extended hepatectomy or trisectionectomy.
Предметные рубрики MeSH
AgedAnastomosis, SurgicalAngiographyArteriovenous Shunt, SurgicalBile Duct NeoplasmsBile Ducts, IntrahepaticChinaCholangiocarcinomaFemaleHepatectomyHepatic ArteryHumansLiver CirculationLiver Failure, AcuteMagnetic Resonance ImagingMaleMicrosurgeryMiddle AgedPatient SafetyPortal VeinPostoperative ComplicationsRetrospective StudiesRisk AssessmentSampling StudiesTomography, X-Ray ComputedTreatment Outcome