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Titolo:
Left hemihepatectomy with microsurgical reconstruction of the right-sided hepatic vasculature - A strategy for preserving hepatic function in patients with proximal bile duct cancer
Autore:
Yamanaka, N; Yasui, C; Yamanaka, J; Ando, T; Kuroda, N; Maeda, S; Ito, T; Okamoto, E;
Indirizzi:
Meiwa Gen Hosp, Nishinomiya, Hyogo 6638186, Japan Meiwa Gen Hosp Nishinomiya Hyogo Japan 6638186 miya, Hyogo 6638186, Japan Hyogo Coll Me, Dept Surg 1, Nishinomiya, Hyogo 6638501, Japan Hyogo Coll Me Nishinomiya Hyogo Japan 6638501 omiya, Hyogo 6638501, Japan Hyogo Med Univ, Dept Dermatol, Nishinomiya, Hyogo 6638501, Japan Hyogo MedUniv Nishinomiya Hyogo Japan 6638501 miya, Hyogo 6638501, Japan
Titolo Testata:
LANGENBECKS ARCHIVES OF SURGERY
fascicolo: 5, volume: 386, anno: 2001,
pagine: 364 - 368
SICI:
1435-2443(200108)386:5<364:LHWMRO>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
LONG-TERM SURVIVAL; HILAR CHOLANGIOCARCINOMA; PORTAL EMBOLIZATION; SURGICAL-TREATMENT; LIVER RESECTION; CARCINOMA; HEPATECTOMY; CONFLUENCE; SURGERY; SEGMENTECTOMY;
Keywords:
proximal bile duct cancer; vascular reconstruction; microsurgery; left hemihepatectomy; right hemihepatectomy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Yamanaka, N Meiwa Gen Hosp, 4-31,Agenaruo Cho, Nishinomiya, Hyogo 6638186,Japan Meiwa Gen Hosp 4-31,Agenaruo Cho Nishinomiya Hyogo Japan 6638186
Citazione:
N. Yamanaka et al., "Left hemihepatectomy with microsurgical reconstruction of the right-sided hepatic vasculature - A strategy for preserving hepatic function in patients with proximal bile duct cancer", LANG ARCH S, 386(5), 2001, pp. 364-368

Abstract

Background: Right hemihepatectomy (RH) for proximal bile duct canceroccasionally results in liver failure. We report the feasibility of left hemihepatectomy (LH) with vascular reconstruction (VR) of the right-sided hilar vessels to preserve hepatic reserve. Methods: Among 110 patients with proximalbile duct cancer (PBC) treated between January 1980 and December 1998, 11 patients underwent LH with VR of eight portal veins and nine hepatic arteries, and 14 underwent RH with VR of four portal veins and one hepatic artery. Microsurgical techniques were used in 80% (8/10) of the hepatic arterial reconstructions. Results: Although operation time was significantly longer in the LH group, hospital mortality, blood loss and incidence of histologically cancer positive margin at the bilioenteric anastomotic site were similar in the two groups. Peak serum liver enzyme concentration was significantly higher in the LH group with longer inflow occlusion time, whereas peak serum total bilirubin concentration was significantly higher in the RH group, which had smaller liver remnant. No liver abscess occurred in any patients who underwent microvascular reconstructions. The cumulative survival of the LH group was worse than that of the RH group, in which the proportion ofvascular invasion was lower, but not significantly. Conclusion: LH with right-sided microvascular reconstruction is technically possible and a feasible option when RH is likely to result in postoperative liver failure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 06:39:52