Effect of hepatic artery resection and reconstruction on the prognosis of patients with advanced hilar cholangiocarcinoma

doi:10.4251/wjgo.v14.i4.887

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World Journal of Gastrointestinal Oncology

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World J Gastrointest Oncol. Apr 15, 2022; 14(4): 887-896
Published online Apr 15, 2022. doi: 10.4251/wjgo.v14.i4.887

Effect of hepatic artery resection and reconstruction on the prognosis of patients with advanced hilar cholangiocarcinoma

Yuan-Ming Li, Zhi-Xin Bie, Run-Qi Guo, Bin Li, Cheng-En Wang, Fei Yan

Yuan-Ming Li, Zhi-Xin Bie, Run-Qi Guo, Bin Li, Cheng-En Wang, Fei Yan, Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China

Author contributions: Li YM and Bie ZX design the study; Guo RQ drafted the work, Li B and Wang CE collected the data; Yan F analysed and interpreted data; Li YM wrote the manuscript; and all the authors reviewed and approved the final version to be published.

Institutional review board statement: This study was approved by the Ethics Committee of Beijing Hospital.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: The authors declared that there is no conflict of interest between them.

Data sharing statement: No additional data are available.

Corresponding author: Yuan-Ming Li, PhD, Associate Chief Physician, Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Street, Dongcheng District, Beijing 100730, China. liym@vip.126.com

Received: November 3, 2021
Peer-review started: November 3, 2021
First decision: December 2, 2021
Revised: December 16, 2021
Accepted: March 5, 2022
Article in press: March 5, 2022
Published online: April 15, 2022
Processing time: 163 Days and 2 Hours

ARTICLE HIGHLIGHTS

Research background

Hilar cholangiocarcinoma (HC) is a good indication for hepatic artery resection, and hepatic artery resection is conducive to radical resection of cholangiocarcinoma. With the continuous development of surgical techniques, especially microsurgery techniques, vascular invasion is no longer a contraindication to surgery. Hepatic artery reconstruction after hepatic artery resection has been used in many centers to treat liver tumors, but it is rarely used in advanced HC.

Research motivation

This study provided treatment strategies for patients with advanced HC.

Research objectives

This study aimed to determine the prognosis of patients with advanced HC after hepatic artery resection and reconstruction.

Research methods

A total of 98 patients with HC who underwent radical operation in our hospital were selected for retrospective analysis.

Research results

The operation time, blood loss, hospitalization time and gastrointestinal function recovery time of the reconstruction group were higher than those of the control group. The R0 resection rates of the reconstruction group and the control group were 90.00% and 72.41%, respectively. In the reconstruction group, serum alanine aminotransferase was lower on the 1^stand 3^rd day after operation, and serum aspartate aminotransferase was lower on the 3^rdday. Although the preoperative Karnovsky performance status score was similar between the groups, it was higher in the reconstruction group 2 wk after the operation. There was no difference in the incidence of complications between the two groups. The 2-year survival rate and 2-year survival time were similar between the groups.

Research conclusions

Radical surgery combined with reconstruction after hepatic artery resection improves R0 resection rate and reduces postoperative liver injury in advanced HC. However, the operation is difficult and the effect on survival time is not clear.

Research perspectives

Hepatic artery resection may be more widely used in advanced HC.