title: Portal vein arterialization as a bridge procedure against acute liver failure after extended hepatectomy for hilar cholangiocarcinoma.
abstract: BACKGROUND
  Acute liver failure (ALF) is a severe and highly fatal complication arising after extended hepatobiliary surgery. The aim of this study was to investigate the primary management experience of portal vein arterialization (PVA) as a bridge procedure to reduce the risk of ALF for hilar cholangiocarcinoma (HCCA) after extended hepatectomy.
  
  
  METHODS
  Between January 2010 and January 2012, 4 patients with HCCA with possible involvement of the right and/or left hepatic artery underwent resectional surgery with reconstruction of the right or left artery blood flow by arterializations of portal vein.
  
  
  RESULTS
  The arteries used for this surgical procedure included gastroduodenal artery (n = 2), common hepatic artery (n = 1), and right gastroepiploic artery (n = 1). PVA was verified as a key point during the course of the disorder between surgery and postoperative recovery. During follow-up, 1 patient suffered secondary portal hypertension and was subsequently cured by interventional artery coil embolization.
  
  
  CONCLUSIONS
  PVA can be indicated where there is arterial involvement in HCCA patients who have undergone extended hepatectomy or trisectionectomy.
authors.affiliation: Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Qiu
authors.affiliation: Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Shuting
authors.initials: S
authors.lastname: Chen
authors.affiliation: Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Prasoon
authors.initials: P
authors.lastname: Pankaj
authors.affiliation: Sichuan University, Chengdu, Sichuan Province, China wuhongjoy@163.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D000792:Angiography / Q000379:methods; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D002681:China; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D008102:Liver Circulation / Q000502:physiology; D017114:Liver Failure, Acute / Q000209:etiology / Q000517:prevention & control*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D061214:Patient Safety; D011169:Portal Vein / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: acute liver failure; extended hepatectomy; hilar cholangiocarcinoma; portal vein arterialization