Interruption of hepatic arterial blood flow after resection of pancreaticobiliary carcinoma.
OBJECTIVE
We reviewed 17 cases of patients with interrupted hepatic arterial blood flow to determine the effect of such an interruption.


METHODS
In 17 patients undergoing radical resection of pancreaticobiliary carcinoma with simultaneous hepatic artery excision (n=15) or intraoperative hepatic artery obstruction (n=2), morbidity and mortality were reviewed. Nine hepatic artery anastomoses were performed in 7 of these patients, and postoperative patency was obtained for 5 anastomoses. The patients were classified into the following groups: group I was 6 patients with complete interruption of hepatic arterial flow to the whole liver or the remnant liver, group II was 6 patients with interruption of hepatic arterial flow to a lobe of the liver, and group III was 5 patients with preservation of hepatic arterial flow.


RESULTS
Disruption of the bilioenteric anastomosis occurred in all 6 patients from group I versus none of those in groups II and III (p<0.05). Liver abscess and liver failure developed in 1 patient each from group I, but the mortality rate in this group was not high.


CONCLUSIONS
Hepatic artery reconstruction in patients with complete interruption of hepatic arterial blood flow appears to be necessary to avoid ischemic breakdown of the bilioenteric anastomosis.
Tsuge
H
H
First Department of Surgery, Okayama University Medical School, Japan.
Mimura
H
H
Hamazaki
K
K
Mori
M
M
Kawata
N
N
Orita
K
K
D000714:Anastomosis, Surgical / Q000379:methods; D001650:Bile Duct Neoplasms / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery*; D006499:Hepatic Artery / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008102:Liver Circulation; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control