HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025
Central hepatectomy for perihilar cholangiocarcinoma: an alternative technique for parenchymal-sparing hepatectomy to prevent post-hepatectomy liver failure.
СтатьяНазвание и аннотация: Перевод в очереди
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Fujisawa Masahiro, Yoshioka Ryuji, Takahashi Atsushi, Irie Shoichi, Takeda Yoshinori, Ichida Hirofumi, Imamura Hiroshi, Kotera Yoshihito, Mise Yoshihiro, Saiura Akio
Аннотация
BACKGROUND: Perihilar cholangiocarcinoma (PHC) often requires major hepatectomy with extrahepatic bile duct resection, carrying the risk of post-hepatectomy liver failure (PHLF). Central hepatectomy (CH), an alternative technique, aims to preserve functional liver reserve. This study evaluated the feasibility of CH and outcomes for patients with PHC within the paradigm of parenchymal-sparing hepatectomy.
METHODS: A retrospective analysis included PHC patients who underwent CH between March 2019 and January 2023. Preoperative evaluations involved multimodality imaging and assessment of future remnant liver volume.
RESULTS: Fourteen patients underwent CH for PHC. Tumor locations were perihilar bile duct (10 patients), and entire extrahepatic bile duct involvement (four patients). Median operative time and intraoperative blood loss were 679.5 min and 450 mL, respectively. Clinically-relevant PHLF occurred in two patients, with one sepsis-related death. Nine patients achieved R0 resection. Functional liver reserve parameters exceeded the standard procedure (p < 0.01).
CONCLUSION: CH for PHC preserves functional liver reserve, potentially reducing PHLF risk. Adequate preoperative evaluation is crucial, and oncological outcomes require further investigation.
METHODS: A retrospective analysis included PHC patients who underwent CH between March 2019 and January 2023. Preoperative evaluations involved multimodality imaging and assessment of future remnant liver volume.
RESULTS: Fourteen patients underwent CH for PHC. Tumor locations were perihilar bile duct (10 patients), and entire extrahepatic bile duct involvement (four patients). Median operative time and intraoperative blood loss were 679.5 min and 450 mL, respectively. Clinically-relevant PHLF occurred in two patients, with one sepsis-related death. Nine patients achieved R0 resection. Functional liver reserve parameters exceeded the standard procedure (p < 0.01).
CONCLUSION: CH for PHC preserves functional liver reserve, potentially reducing PHLF risk. Adequate preoperative evaluation is crucial, and oncological outcomes require further investigation.