イズモ　ワタル   IZUMO Wataru   出雲　渉    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Hepatic artery resection without reconstruction in pancreatoduodenectomy.
掲載誌名	正式名：Langenbeck's archives of surgery 略　 称：Langenbecks Arch Surg ISSNコード：14352451/14352443
掲載区分	国外
巻・号・頁	406(6),pp.2081-2090
著者・共著者	Burasakarn Pipit, HIGUCHI Ryota, YAZAWA Takehisa, UEMURA Shuichiro, IZUMO Wataru, MATSUNAGA Yutaro, YAMAMOTO Masakazu
発行年月	2021/09
概要	PURPOSE:It has been reported that there are left and right hepatic arterial arcades via the blood vessels around the hilar bile duct; therefore, when the hilar bile duct is preserved, hepatic artery reconstruction may not be necessary. We compared the short-term and long-term outcomes in patients with distal cholangiocarcinoma who underwent pancreatoduodenectomy (PD) with right hepatic artery resection without right hepatic artery reconstruction (RHAR group) with those patients who underwent conventional PD.METHODS:All data were retrospectively collected from patient records. A 1:4-propensity score-matched case-control study was conducted in patients with distal cholangiocarcinoma who received treatment at Tokyo Women's Medical University from February 1985 to April 2015.RESULTS:There was no statistical difference in the overall morbidity rate between the two groups. No patient in the RHAR group (10 patients) had liver failure, liver abscess, or cholangitis in the postoperative period; one patient died postoperatively because of a bleeding pseudoaneurysm in the gastroduodenal artery. The PD group (40 patients) had a significantly better median time regarding the recurrence (34 vs. 11 months, p=0.027) and 5-year disease-free survival (35% vs. 10%, p=0.027) rates than the RHAR group, which may be attributed to the presence of a more severe disease in patients in the RHAR group.CONCLUSION:We concluded that pancreaticoduodenectomy with right hepatic artery resection without reconstruction has a comparable overall morbidity rate with that of a conventional pancreaticoduodenectomy surgery and may be performed as an alternative procedure when tumor invasion of the right hepatic artery is suspected.
DOI	10.1007/s00423-021-02178-w
PMID	33932159