CAJ | 학술논문

目的探讨肝动脉切除显微外科重建在肝门部胆管癌根治术中的治疗经验和应用价值.方法回顾性分析2008年8月至2012年3月采用左半肝切除+右肝动脉切除重建伴或不伴门静脉切除重建治疗肝门部胆管癌的7例临床资料.结果左肝动脉与右肝动脉吻合1例,右肝动脉与右肝动脉对端吻合1例,胃十二指肠动脉与右肝动脉吻合1例,肝固有动脉与右肝动脉吻合4例,伴门静脉切除重建2例.术后病理学检查:中-低分化腺癌2例,低分化腺癌3例,乳头状腺癌2例.手术:R0切除6例,R1切除1例.术后无肝功能衰竭、肝坏死、肝脓肿、胆肠吻合口瘘等并发症及围手术期死亡发生.结论肝动脉切除显微外科重建提高了进展期肝门部胆管癌的根治切除率,有效控制了术后并发症,安全可行.
목적 탐토간동맥절제현미외과중건재간문부담관암근치술중적치료경험화응용개치.방법 회고성분석2008년8월지2012년3월채용좌반간절제+우간동맥절제중건반혹불반문정맥절제중건치료간문부담관암적7례림상자료.결과 좌간동맥여우간동맥문합1례,우간동맥여우간동맥대단문합1례,위십이지장동맥여우간동맥문합1례,간고유동맥여우간동맥문합4례,반문정맥절제중건2례.술후병이학검사:중-저분화선암2례,저분화선암3례,유두상선암2례.수술:R0절제6례,R1절제1례.술후무간공능쇠갈、간배사、간농종、담장문합구루등병발증급위수술기사망발생.결론 간동맥절제현미외과중건제고료진전기간문부담관암적근치절제솔,유효공제료술후병발증,안전가행.
Objective To evaluate hepatic artery resection and microsurgical reconstruction in radical resection of Klatskin's tumor.Methods We retrospectively reviewed clinical data of 7 patients with advanced hilar cholangiocarcinoma (Klatskin's tumor) who underwent left hemihepatectomy combined with right hepatic artery resection and microsurgical reconstruction with or without portal vein reconstruction from August 2008 to March 2012.Results Right hepatic artery was reconstructed with end-to-end anastomosis,using the reserved left hepatic artery (n =1),the remanent right hepatic artery (n =1),the hepatic artery proper (n =4) and the gastroduodenal artery (n =1),among those 2 patients underwent concomitant portal vein reconstruction.Post-operative pathology showed middle to low differentiated adenocarcinoma in 2 patients,low differentiated adenocarcinoma in 3 and papillary adenocarcinoma in 2.R0 resection was achieved in 6 patients.There was no post-operative liver failure,biliary-enteric anastomotic leakage or perioperative deaths.Conclusions Hepatic artery resection and microsurgical reconstruction increases the radical resection rate of advanced hilar cholangiocarcinoma and decreases postoperative complications.