Use of an autologous liver round ligament flap zeros postoperative bile leak after curative resection of hilar cholangiocarcinoma.
BACKGROUND
Postoperative bile leak is a major surgical morbidity after curative resection with hepaticojejunostomy for hilar cholangiocarcinoma, especially in Bismuth-Corlette types III and IV. This retrospective study assessed the effectiveness and safety of an autologous hepatic round ligament flap (AHRLF) for reducing bile leak after hilar hepaticojejunostomy.


METHODS
Nine type III and IV hilar cholangiocarcinoma patients were consecutively hospitalized for elective perihilar partial hepatectomy with hilar hepaticojejunostomy using an AHRLF between October 2009 and September 2013. The AHRLF was harvested to reinforce the perihilar hepaticojejunostomy. Main outcome measures included operative time, blood loss, postoperative recovery times, morbidity, bile leak, R0 resection rate, and overall survival.


RESULTS
All patients underwent uneventful R0 resection with hilar hepaticojejunostomy. No patient experienced postoperative bile leak.


CONCLUSIONS
The AHRLF was associated with lack of bile leak after curative perihilar hepatectomy with hepaticojejunostomy for hilar cholangiocarcinoma, without compromising oncologic safety, and is recommended in selected patients.
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110000, China.
Da-Xin
DX
Sun
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110000, China.
Xiao-Dong
XD
Tan
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110000, China.
Feng
F
Gao
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110000, China.
Jin
J
Xu
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110000, China.
Dong-Xu
DX
Cui
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110000, China.
Xian-Wei
XW
Dai
D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology* / Q000601:surgery*; D001646:Bile; D001650:Bile Duct Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D018285:Klatskin Tumor / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D000069592:Round Ligament of Liver; D013524:Surgical Flaps; D016896:Treatment Outcome