Background: Radical surgery for Bismuth type III/IV hilar cholangiocellular carcinoma, which was usually considered unresectable, seems to improve prognosis by increasing the surgical curability rate. However, the dilemma of multiple billiary stumps and high postoperative complication rate caused by hepato-enteric anastomosis has been the main impediment. Thus, we practiced and introduce a new technique called "basin-shaped" hepaticojejunostomy to improve the treatment.
Methods: Thirty-two cases with Bismuth type III/IV hilar cholangiocarcinoma admitted to our department from Aug. 2013 to Dec. 2015 and who underwent hilar resection and resection segment 4(or plus resection segment 1) were reconstructed by "basin-shaped" hepaticojejunostomy. The clinical data were collected and analyzed.
Results: All patients underwent successful R0 high hilar resection following basin-shaped hepaticojejunostomy and were discharged from the hospital without severe postoperative complications. The average operation time for hepato-enteric anastomosis was 42.1 ± 8.5 min. The postoperative bile leakage rate was 3.1% (1/32), and the biliary infection rate was 6.2% (2/32). Within a median follow-up of 25.6 months, none of the patients developed local recurrence around the hepato-enteric anastomosis.
Conclusions: For patients with Bismuth type III/IV hilar cholangiocellular carcinoma who underwent resection segment 4(or plus resection segment 1), basin-shaped hepaticojejunostomy was a safe, simple and valid method for bile duct reconstruction, with a relatively low incidence of postoperative complications.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585136 | PMC |
| http://dx.doi.org/10.1186/s12876-019-1012-2 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Stent insertion for malignant hilar obstruction: a meta-analysis of percutaneous versus endoscopic approaches.
Prz Gastroenterol
July 2023
Department of Radiology, Xuzhou Central Hospital, Xuzhou, China.
Introduction: In an effort to treat patients with malignant hilar obstruction (MHO), both percutaneous trans-hepatic biliary stenting (PTBS) and endoscopic biliary stenting (EBS) strategies have been implemented in the clinic, but the relative advantages of these techniques remain to be clarified.
Aim: This meta-analysis was designed to compare the relative clinical efficacy of PTBS and EBS in MHO patients.Material and methods: Relevant studies were identified through searches of the PubMed, Web of science, and Wanfang databases, and pooled analyses of these studies were then performed.
The assessment of postoperative cholangitis in malignant biliary obstruction: a real-world study of nasobiliary drainage after endoscopic placement of self-expandable metal stent.
Front Oncol
November 2024
Department of Abdominal Surgery, Guiqian International General Hospital, Guiyang, Guizhou, China.
Objectives: Endoscopic retrograde cholangiopancreatography(ERCP) with endoscopic metallic biliary endoprosthesis(EMBE) serves as a crucial palliative treatment for advanced malignant biliary obstruction(MBO). While endoscopic nasobiliary drainage(ENBD) effectively reduces post-ERCP cholangitis (PEC) incidence, its impact on PEC in MBO patients is unclear. This study evaluates ENBD's effects on PEC in patients undergoing EMBE and identifies risk factors.
View Article and Find Full Text PDFLarge cell carcinoma of the lung: LDCT features and survival in screen-detected cases.
Eur J Radiol
October 2024
Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), the German Center for Lung Research (DZL), Heidelberg, Germany.
Purpose: To investigate the early radiological features and survival of Large Cell Carcinoma (LCC) cases diagnosed in low-dose computed tomography (LDCT) screening trials.
Methods: Two radiologists jointly reviewed the radiological features of screen-detected LCCs observed in NLST, ITALUNG, and LUSI trials between 2002 and 2016, comprising a total of 29,744 subjects who underwent 3-5 annual screening LDCT examinations. Survival or causes of death were established according to the mortality registries extending more than 12 years since randomization.
"Hepatic hilum area priority, liver posterior first": An optimized strategy in laparoscopic resection for type III-IV hilar cholangiocarcinoma.
World J Gastrointest Surg
July 2024
Department of Hepatopancreatobiliary Surgery, Anhui No. 2 Provincial People's Hospital, Hefei 230041, Anhui Province, China.
Background: In recent years, pure laparoscopic radical surgery for Bismuth-Corlette type III and IV hilar cholangiocarcinoma (HCCA) has been preliminarily explored and applied, but the surgical strategy and safety are still worthy of further improvement and attention.
Aim: To summarize and share the application experience of the emerging strategy of "hepatic hilum area dissection priority, liver posterior separation first" in pure laparoscopic radical resection for patients with HCCA of Bismuth-Corlette types III and IV.
Methods: The clinical data and surgical videos of 6 patients with HCCA of Bismuth-Corlette types III and IV who underwent pure laparoscopic radical resection in our department from December 2021 to December 2023 were retrospectively analyzed.
Right hepatectomy compared with left hepatectomy for resectable Klatskin tumor: A systematic review across tumor types.
Surgery
October 2024
Hepato-Biliary-Pancreatic Surgery Division, and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Article Synopsis
- Klatskin tumors have a poor prognosis, and achieving R0 surgical margins through radical surgery is crucial for better long-term outcomes.
- This systematic review compares left and right hepatectomy procedures to determine their effectiveness based on the type and spread of Klatskin tumors.
- The analysis of 21 studies suggests that while both surgeries yield similar long-term results for type III/IV tumors, left hepatectomy may offer slightly better outcomes and fewer complications for type I/II tumors.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!