Chen Yongliang, Liu Zhiwei, Duan Weidong, Huang Xiaoqiang, Lv Wenping, Tong Junxiang, Dong Jiahong, Huang Zhiqiang
Hepatogastroenterology. 2014 Jan-Feb;61(129):9-11.
BACKGROUND/AIMS: The resection and reconstruction of hepatic artery is often required in radical surgery for hilar cholangiocarcinoma. In this study, we reported our experience in performing the arterioportal shunting with restriction of the arterial caliber as an alternative for the arterial reconstruction on the basis of our experiment when reconstruction of hepatic artery is impossible.
Eight patients with hilar cholangiocarcinoma underwent extended left hepatectomy and caudate lobectomy combined with en bloc resection of hepatic artery and arterioportal shunting with restriction of the arterial caliber. The efficacy of arterioportal shunting and restriction of the arterial caliber in preventing complications of arterioportal shunting were assessed by computed tomography angiography (CTA) perioperational period and 2 years follow-up after the operation.
Eight patients recovered uneventfully without any complication. CTA showed a patent shunt and normal liver regeneration. No signs of portal hypertension were found in two years of follow-up.
Arterioportal shunting with restriction of the arterial caliber appears to be a feasible and safe alternative for the microvascular reconstruction after hepatic artery resection in radical surgery for hilar cholangiocarcinoma.
背景/目的：肝门部胆管癌根治性手术常需行肝动脉切除与重建。在本研究中，我们报告了在肝动脉无法重建的情况下，基于我们的实验，采用限制动脉管径的动门脉分流术作为动脉重建替代方法的经验。
8例肝门部胆管癌患者接受了扩大左肝切除及尾状叶切除，联合肝动脉整块切除及限制动脉管径的动门脉分流术。通过围手术期计算机断层血管造影（CTA）及术后2年随访评估动门脉分流术及限制动脉管径在预防动门脉分流术并发症方面的疗效。
8例患者均顺利康复，无任何并发症。CTA显示分流道通畅，肝脏再生正常。随访2年未发现门静脉高压迹象。
限制动脉管径的动门脉分流术似乎是肝门部胆管癌根治性手术中肝动脉切除后微血管重建的一种可行且安全的替代方法。
