Surgical approaches for carcinoma of the hepatic duct confluence with hepatic vascular resection and reconstruction.

Miyazaki, Masaru; Udagawa, Ikuo; Koshikawa, Hisao; Iinuma, Katsuhiro; Itoh, Hiroshi; Kanno, Yayoi; Kumura, Fumio; Matsumoto, Jun; Isono, Toshio; Suzuki, Hirouki; Koyama, Takashi; Shimoda, Tsukasa; Nakagawa, Kohji; Okui, Katsuji; Hayashida, Kazuya; Suwa, Toshikazu

doi:10.5833/jjgs.23.2772

Cited by 3 publications

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“…However, we decided not to resect this artery, instead undertaking dissection of the tumor from the arterial wall with the ultrasound surgical aspirator. Miyazaki et al 8 have reported that combined resection of the hepatic artery does not always increase histological curability, and, in our patient, tumor invasion of the resected artery was not found histologically. Combined resection of the hepatic artery was, therefore, not necessary for the operation to be curative, but weakness of the arterial wall caused by the dissection seems to have led to the subsequent rupture.…”

Section: Discussionmentioning

confidence: 76%

Rupture of the hepatic artery after left hemihepatectomy for hilar bile duct carcinoma

Tanaka

Hirohashi

Ohta³

et al. 1995

J Hep Bil Pancr Surg

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Hilar bile duct carcinoma has a poor prognosis, but this has been improved in recent years by an aggressive surgical approach. We treated a 73-year-old woman who had obstructive jaundice due to bile duct carcinoma at the hepatic hilum. The jaundice decreased after percutaneous transhepatic biliary drainage. The tumor was resected with the left and caudate lobe of the liver and a part of portal vein. The right hepatic artery was located behind the common hepatic duct, and was suspected to be invaded by the tumor. We dissected the tumor from the arterial wall without carrying out combined resection of the hepatic artery. On the 6th postoperative day, the hepatic artery ruptured and the patient suffered hypovolemic shock. Resection of the hepatic artery and reconstruction were done, but the patient died 2 days later. Histological examination of the resected artery showed that the tumor had been curatively removed by dissection and that no tumor remained at the arterial wall. The rupture of the right hepatic artery was thought to have been caused by damage to the wall during the dissection procedure.

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Section: Discussionmentioning

confidence: 76%

Rupture of the hepatic artery after left hemihepatectomy for hilar bile duct carcinoma

Tanaka

Hirohashi

Ohta³

et al. 1995

J Hep Bil Pancr Surg

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Invasive growth patterns of hepatic hilar ductal carcinoma. A histologic analysis of 18 surgical cases

Hayashi

Miyazaki

Kondō

et al. 1994

Cancer

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Background. Postoperative recurrence of hepatic hilar ductal carcinoma usually occurs in a localized region around the surgical margin, such as the bile duct. This study was aimed at assessing the invasive patterns of the hepatic hilar ductal carcinoma by histologically examining surgical specimens obtained by extended liver resection, especially the involvement of intrahepatic duct. Methods. Eighteen resected specimens of hepatic hilar ductal carcinoma were histologically investigated. Multiple sections vertical to the extrahepatic and intrahepatic bile duct were made at a 5‐mm interval. The extension of carcinoma was evaluated on each of three layers (mucosal, extramucosal‐intramural, and extramural), and routes of the invasion were examined. Results. Extramucosal extent toward the hepatic side was observed in 14 patients (77.8%) and that toward the duodenal side in 8 patients (44.4%) (P ≤ 0.05). The distance of extramucosal tumor extent was also significantly longer (P ≤ 0.05) in the hepatic side than in the duodenal side. Histologic tumor margin was usually identified in the extramural layer. Two patients had discontinuous extramucosal invasion. The lymphatic invasions were observed most frequently, followed by perineural invasion, and venous invasion was rare. In the extramucosal invasion of the liver, the left dominant carcinomas had extended toward the left, whereas those right dominant had extended toward the right (P ≤ 0.05). Well differentiated tubular adenocarcinomas extended to the liver more extensively than moderately and poorly differentiated ones, but not significantly. Conclusions. The authors examined the extramucosal invasion of hepatic hilar ductal carcinoma. This invasion extended more frequently and further to the hepatic side than to the duodenal side, usually by the route of the extramural layer. Cancer 1994; 73:2922–9.

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A Left Hemihepatectomy and a Right Hepatic Artery Reconstruction Involving the Left Hepatic Artery for Cholangiocellular Carcinoma

Nakayama¹,

Hataya²,

Ono³

et al. 2008

Nihon Rinsho Geka Gakkai Zasshi (J Jpn Surg Assoc)

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Surgical approaches for carcinoma of the hepatic duct confluence with hepatic vascular resection and reconstruction.

Cited by 3 publications

References 0 publications

Rupture of the hepatic artery after left hemihepatectomy for hilar bile duct carcinoma

Rupture of the hepatic artery after left hemihepatectomy for hilar bile duct carcinoma

Invasive growth patterns of hepatic hilar ductal carcinoma. A histologic analysis of 18 surgical cases

A Left Hemihepatectomy and a Right Hepatic Artery Reconstruction Involving the Left Hepatic Artery for Cholangiocellular Carcinoma

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