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

摘要

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 tissue.With continuous development of surgical techniques,especially microsurgical technique,vascular invasion is no longer a contraindication to surgery in the past 10 years.However,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 HC.AIM To determine the prognosis of patients with advanced HC after hepatic artery resection and reconstruction.METHODS A total of 98 patients with HC who underwent radical operation in our hospital were selected for this retrospective analysis.According to whether the patients underwent hepatic artery resection and reconstruction or not,they were divided into reconstruction(n=40)and control(n=58)groups.The traumatic indices,surgical resection margin,liver function tests before and after the operation,and surgical complications were compared between the two groups.RESULTS Operation time,blood loss,hospital stay,and gastrointestinal function recovery time were higher in the reconstruction group than in the control group(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 mo)were similar between the groups(P>0.05).CONCLUSION Radical surgery combined with reconstruction after hepatic artery resection improves R0 resection rate and reduces postoperative liver injury in advanced HC.However,the operation is difficult and the effect on survival time is not clear.