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Arterioportal shunting as an alternative to microvascular reconstruction after hepatic artery resection.

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Title: Arterioportal shunting as an alternative to microvascular reconstruction after hepatic artery resection.
Authors: Kondo, S. Browse this author →KAKEN DB
Hirano, S. Browse this author
Ambo, Y. Browse this author
Tanaka, E. Browse this author
Kubota, T. Browse this author
Katoh, H. Browse this author
Issue Date: Feb-2004
Publisher: British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Journal Title: British Journal of Surgery
Volume: 91
Issue: 2
Start Page: 248
End Page: 251
Publisher DOI: 10.1002/bjs.4428
PMID: 14760676
Abstract: Background: Portal vein and hepatic artery resection and reconstruction may be required in radical surgery for biliary cancer. Microvascular reconstruction requires special equipment and training, and may be difficult to accomplish when the arterial stump is small, when there are multiple vessels or when the stump lies deep within the wound. This study examined the feasibility and safety of arterioportal shunting as an alternative to arterial reconstruction. Methods: Over 30 months, ten patients with biliary cancer (six bile duct and four gallbladder carcinomas) underwent radical surgery with en bloc resection of the hepatic artery and end-to-side arterioportal reconstruction between the common hepatic or gastroduodenal artery and the portal trunk. Results: No patient died. Complications included bile leakage in two patients and liver abscess in one. Routine angiography performed 1 month after surgery revealed shunt occlusion in three patients. Once the existence of hepatopetal arterial collaterals had been confirmed in the remaining patients, the shunt was occluded by coil embolization. Conclusion: Arterioportal shunting appears to be a safe alternative to microvascular reconstruction after hepatic artery resection. However, the safety of the procedure and its potential to increase the cure rate require further assessment in a larger series with a longer follow-up. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Rights: Copyright © 2004 John Wiley & Sons, Inc., British Journal of Surgery, Vol. 91-2, pp. 248-251
Relation: http://www.interscience.wiley.com/
Type: article (author version)
URI: http://hdl.handle.net/2115/15851
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 近藤 哲

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