Safety of combined resection of the middle hepatic artery in right hemihepatectomy for hilar biliary malignancy.
Safety of combined resection of the middle hepatic artery in right hemihepatectomy for hilar biliary malignancy.
复制标题
肝中动脉联合切除术治疗肝门部胆道恶性肿瘤右半肝切除术的安全性。
DOI：
10.1007/s00534-009-0107-5
复制
发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Kentaro Kato
中科院分区：
文献类型：
--
作者：
S. Hirano;S. Kondo;Eiichi Tanaka;T. Shichinohe;T. Tsuchikawa;Kentaro Kato
背景/目的在肝门部胆管恶性肿瘤患者中，保留靠近肝门部肿瘤的肝中动脉（MHA，IV段动脉）可能导致切除时切缘阳性。这项回顾性研究评估的安全性相结合的切除MHA右半肝切除术，尾状叶切除术，胆管切除术肝门部胆管malignances.MethodsOf 61例肝门部胆管恶性肿瘤谁接受右半肝切除术，我们分类的分支模式的MHA根据在门的起源和课程。16例动脉走行靠近肿瘤的患者行MHA切除，未行重建。我们比较了这些患者的围手术期结果与那些没有接受切除的artery. ResultsAnatomical，MHA运行在右侧的门静脉脐部的40例（66%）患者。接受联合切除术的患者的围手术期数据与保留MAH的患者相似。有没有术后并发症，可能是直接相关的动脉surgence.ConclusionsCombined切除的MHA在右半肝切除术的肝门部胆管恶性肿瘤有一个安全的围手术期。
Background/purposeIn patients with hilar biliary malignancies, preservation of the middle hepatic artery (MHA, segment IV artery) where it runs close to the tumor in the hepatic hilum may lead to resection with positive margins. This retrospective study assessed the safety of combined resection of the MHA with right hemihepatectomy, caudate lobectomy, and bile duct resection for hilar biliary malignancies.MethodsOf 61 patients with hilar biliary malignancies who underwent right hemihepatectomy, we classified the branching patterns of the MHA according to the origins and courses in the hilum. The MHA was resected without reconstruction in 16 patients in whom the artery ran close to the tumor. We compared the perioperative outcomes in these patients with those of patients who did not undergo resection of the artery.ResultsAnatomically, the MHA ran on the right side of the umbilical portion of the portal vein in 40 (66%) patients. Perioperative data for the patients who underwent combined resection were similar to those in whom the MAH was preserved. There were no postoperative complications that could be directly related to the arterial resection.ConclusionsCombined resection of the MHA during right hemihepatectomy for hilar biliary malignancies has a safe perioperative course.