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3
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World J Gastrointest Surg. 2019 Jun 27;11(6):279-286. doi: 10.4240/wjgs.v11.i6.279.
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Ann Gastroenterol Surg. 2019 May 22;3(4):378-389. doi: 10.1002/ags3.12266. eCollection 2019 Jul.
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Capecitabine compared with observation in resected biliary tract cancer (BILCAP): a randomised, controlled, multicentre, phase 3 study.卡培他滨对比观察用于可切除胆管癌（BILCAP）：一项随机、对照、多中心、3 期研究。
Lancet Oncol. 2019 May;20(5):663-673. doi: 10.1016/S1470-2045(18)30915-X. Epub 2019 Mar 25.
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肝门部胆管癌同期肝动脉切除与重建的短期和长期结局

Short- and Long-Term Outcomes of Simultaneous Hepatic Artery Resection and Reconstruction for Perihilar Cholangiocarcinoma.

作者信息

Shindo Yoshitaro, Kobayashi Shogo, Wada Hiroshi, Tokumitsu Yukio, Matsukuma Satoshi, Matsui Hiroto, Nakajima Masao, Yoshida Shin, Iida Michihisa, Suzuki Nobuaki, Takeda Shigeru, Hoshii Yoshinobu, Eguchi Hidetoshi, Nagano Hiroaki

机构信息

Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.

Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

出版信息

Gastrointest Tumors. 2021 Jan;8(1):25-32. doi: 10.1159/000511164. Epub 2020 Nov 10.

DOI:10.1159/000511164
PMID:33728293
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7942164/
Abstract

INTRODUCTION

Because surgical resection with simultaneous hepatic artery (HA) resection and reconstruction for perihilar cholangiocarcinoma (PHC) is technically demanding, the surgical indication for this challenging procedure is controversial. Thus, this study aimed to evaluate the efficacy of simultaneous HA resection and reconstruction for PHC.

METHODS

Between January 2002 and January 2018, 13 patients with PHC underwent surgical intervention with simultaneous resection and reconstruction of the HA at Yamaguchi University Hospital (Ube, Japan) and Osaka University Hospital (Suita, Japan).

RESULTS

There were 2 cases (15.4%) of 90-day postoperative mortality. Nine patients (69.2%) developed major postoperative complications (Clavien-Dindo classification ≥IIIa). Curative resections (R0) were achieved in 8 cases (61.5%). The median survival time (MST) and 1- and 3-year survival rates after resection (including in-hospital deaths) were 20.9 months and 61.5 and 10.3%, respectively. The MST and 1- and 2-year survival rates of 8 patients who underwent R0 resection were significantly better than those of the other 5 patients (24.2 vs. 10.2 months, 75.0 vs. 40.0%, and 50.0 vs. 0.0%, respectively, = 0.0228).

CONCLUSIONS

Simultaneous HA resection and reconstruction is technically possible and may provide long-term survival in selected patients with locally advanced PHC.

摘要

引言

由于肝门部胆管癌（PHC）同时行肝动脉（HA）切除及重建的手术切除技术要求高，这一具有挑战性的手术的适应证存在争议。因此，本研究旨在评估PHC同时行HA切除及重建的疗效。

方法

2002年1月至2018年1月期间，13例PHC患者在山口大学医院（日本宇部）和大阪大学医院（日本吹田）接受了HA同时切除及重建的手术干预。

结果

术后90天死亡率为2例（15.4%）。9例患者（69.2%）发生了严重术后并发症（Clavien-Dindo分级≥IIIa）。8例（61.5%）实现了根治性切除（R0）。切除术后（包括院内死亡）的中位生存时间（MST）以及1年和3年生存率分别为20.9个月、61.5%和10.3%。8例行R0切除患者的MST以及1年和2年生存率显著优于其他5例患者（分别为24.2个月对10.2个月、75.0%对40.0%、50.0%对0.0%，P = 0.0228）。

结论

同时行HA切除及重建在技术上是可行的，可能为部分局部晚期PHC患者提供长期生存。