Portal vein resection and reconstruction prior to hepatic dissection during right hepatectomy and caudate lobectomy for hepatobiliary cancer.
BACKGROUND
Hepatobiliary cancer invading the hilar bile duct often involves the portal bifurcation. Portal vein resection and reconstruction is usually performed after completion of the hepatectomy. This retrospective study assessed the safety and usefulness of portal vein reconstruction prior to hepatic dissection in right hepatectomy and caudate lobectomy plus biliary reconstruction, one of the common procedures for radical resection.


METHODS
Clinical characteristics and perioperative results were compared in patients who underwent right hepatectomy and caudate lobectomy plus biliary reconstruction with (ten patients) and without (11 patients) portal reconstruction from September 1998 to March 2002.


RESULTS
All ten portal vein reconstructions were completed successfully before hepatic dissection; the portal cross-clamp time ranged from 15 to 41 (median 22) min. Blood loss, blood transfusion during the operation, postoperative liver function, morbidity and length of hospital stay were similar in the two groups. No patient suffered postoperative hepatic failure or death.


CONCLUSIONS
This study demonstrates that portal vein reconstruction does not increase the morbidity or mortality associated with right hepatectomy and caudate lobectomy with biliary reconstruction. This approach facilitates portal vein reconstruction for no-touch resection of hepatobiliary cancer invading the hilar bile duct.
Kondo
S
S
Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo 060-8638, Japan. kondows@med.hokudai.ac.jp
Katoh
H
H
Hirano
S
S
Ambo
Y
Y
Tanaka
E
E
Okushiba
S
S
D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001663:Bilirubin / Q000097:blood; D001803:Blood Transfusion; D018281:Cholangiocarcinoma / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000601:surgery; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D011169:Portal Vein / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome
D001663:Bilirubin