Significance of Vascular Resection and Reconstruction in Surgery for Hilar Cholangiocarcinoma: With Special Reference to Hepatic Arterial Resection and Reconstruction

Matsuyama, Ryusei; Mori, Rintaro; Ota, Yoshihide; Homma, Yoshimi; Kumamoto, Takafumi; Takeda, Kazuhisa; Morioka, Daisuke; Maegawa, Jiro; Endo, Itaru

doi:10.1245/s10434-016-5381-2

Cited by 58 publications

(65 citation statements)

References 32 publications

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“…No differences in morbidity rates were observed in most of the published studies (17)(18)(19)(20)(21)(22)25,(27)(28)(29)46), as it was the case in the present series. Only one study showed significantly increased morbidity rates when a PVR is performed (23).…”

Section: Discussionsupporting

confidence: 61%

“…The reported portal vein thrombosis rates after curative-intent surgery for PHC with PVR in the previous series vary between 0% and 10% (17,22,23,25,26,30,45) and appears to be significantly higher compared with the patients without a PVR (30). In the present series of patients with a PVR, the portal vein thrombosis rate was 9.5%, not significantly different from the group of patients without a PVR.…”

Section: Discussioncontrasting

confidence: 55%

“…Regarding the early outcomes, some studies associated a PVR with trends towards increased mortality rates (15,24,27,49) while others did not (6,11,(18)(19)(20)(21)(22)(23)25,28), as it was the case in the present series. No differences in morbidity rates were observed in most of the published studies (17)(18)(19)(20)(21)(22)25,(27)(28)(29)46), as it was the case in the present series.…”

Section: Discussionmentioning

confidence: 42%

“…Although challenging, the safety of a portal vein resection (PVR) during curative-intent surgery for PHC has been demonstrated in several studies (6,7,11,(18)(19)(20). However, the impact of a PVR in PHC surgery remains controversial and previous comparative studies reached conflicting results (5,7,11,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), none including patients from Eastern Europe. Furthermore, meta-analyses comparing the outcomes of patients with and without a PVR for PHC did not reach the same conclusions (29)(30)(31)(32)(33).…”

Section: Introductionmentioning

confidence: 99%

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Curative-intent Surgery for Perihilar Cholangiocarcinoma with and without Portal Vein Resection - A Comparative Analysis of Early and Late Outcomes

Dumitraşcu¹,

Stroescu²,

Brasoveanu³

et al. 2017

chr

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Introducere: Siguranţa rezecţiei de venă portă în chirurgia colangiocarcinoamelor perihilare a fost deja dovedită în Asia, America şi Europa de Vest. Totuşi, nu există nici un fel de date referitoare la acest subiect, care să provină din Europa de Est. Scopul studiului este de a evalua comparativ rezultatele postoperatorii imediate şi pe termen lung după rezecţia cholangiocarcinoamelor perihilare, cu şi fără rezecţie de venă portă. Pacienţi şi metode: Datele a 21 de pacienţi rezecaţi pentru colangiocarcinoame perihilare ce au asociat rezecţia venei porte au fost comparate cu datele a 102 pacienţi fără rezecţie de venă portă. Pentru analiza comparativă a datelor din cele două grupuri s-au folosit teste statistice specifice. Rezultate: Rezecţia venei porte a fost realizată la 17% dintre pacienţi. În grupul pacienţilor cu rezecţie asociată de venă portă au fost realizate semnificativ mai multe trisecţionectomii drepte (p = 0.031) şi rezecţii de lob caudat (p = 0.049). Ca urmare, atât timpul operator (p = 0.015) cât şi pierderea de sânge intraoperator (p = 0.002) au fost semnificativ mai mari în acest grup de pacienţi cu rezecţie de venă portă. Nu s-au constatat diferenţe semnificative între cele două grupuri de pacienţi în ceea ce priveşte rata complicaţiilor severe postoperatorii, mortalitatea postoperatorie şi chimioterapia adjuvantă. Totuşi, în grupul pacienţilor cu rezecţie de venă portă, rata insuficenţei hepatice postoperatorii cu impact clinic

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Section: Discussionsupporting

confidence: 61%

Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 42%

Section: Introductionmentioning

confidence: 99%

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Curative-intent Surgery for Perihilar Cholangiocarcinoma with and without Portal Vein Resection - A Comparative Analysis of Early and Late Outcomes

Dumitraşcu¹,

Stroescu²,

Brasoveanu³

et al. 2017

chr

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“…Compared with the HA, the PV is relatively easy to include in combined resection and reconstruction such as wedge resection is also simpler (19), so invasion to the PV is no longer considered a contraindication for surgery and is less important than the evaluation of arterial invasion. Vascular invasion of the HA is still a contraindication and combined resection and reconstruction of the HA is technically challenging (20). From the results of our study, we consider surgery when the tumor is close to the HA on CT but no obvious encasement is visualized on convex EUS.…”

Section: Discussionmentioning

confidence: 97%

Utility of convex EUS for preoperative vascular evaluation of malignant biliary tract neoplasm

et al. 2017

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Abstract. The aim of the present study was to examine the utility of convex endoscopic ultrasonography (EUS) for the preoperative vascular evaluation of malignant biliary tract neoplasm, by comparing EUS findings with histological findings from resected specimens. Between January 2008 and January 2016, the present study retrospectively retrieved 82 cases diagnosed with malignant biliary tract neoplasm to compare findings from convex EUS with histological findings from resected specimens. A total of four groups were defined according to the results of EUS of the hepatic artery (HA) and portal vein (PV): Group 1, hyperechoic tissue between tumor and vessel; group 2, close proximity between tumor and vessel without loss of hyperechoic tissue; group 3, tumor and vessel contiguity, with loss of hyperechoic tissue; and group 4, encasement >180˚. Regarding the HA, all 17 cases in groups 2 and 3 in which the tumor was close to the HA however no obvious encasement was evident, demonstrated no histological invasion, or the HA could be separated from the tumor intraoperatively. However, this was not the case for the portal vein. Of the six cases in group 3, 4 cases (66.7%) demonstrated PV invasion. Overall, convex EUS is useful for the preoperative evaluation of malignant biliary tract neoplasms, and surgery may be considered when the tumor is close to the HA on computed tomography scans, however there is no obvious encasement visualized by convex EUS.

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Cholangiocarcinoma

Labib

Fusai

Pereira

2019

Evidence‐based Gastroenterology and Hepatology 4e

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Significance of Vascular Resection and Reconstruction in Surgery for Hilar Cholangiocarcinoma: With Special Reference to Hepatic Arterial Resection and Reconstruction

Abstract: CRR of the HA was considered efficacious in selected patients; however, long-term outcomes of the VR-A group seem unsatisfactory. Treatments additional to surgery may be necessary in cases requiring CRR of the HA.

Cited by 58 publications

References 32 publications

Curative-intent Surgery for Perihilar Cholangiocarcinoma with and without Portal Vein Resection - A Comparative Analysis of Early and Late Outcomes

Curative-intent Surgery for Perihilar Cholangiocarcinoma with and without Portal Vein Resection - A Comparative Analysis of Early and Late Outcomes

Utility of convex EUS for preoperative vascular evaluation of malignant biliary tract neoplasm

Cholangiocarcinoma

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