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Application of a Gastroduodenal Artery Graft for Reconstruction of the Hepatic Artery during Radical Resection of Hilar Cholangiocarcinoma.

Liang Y, Wang J, Shi X, Dong J, Gu W - Gastroenterol Res Pract (2015)

Bottom Line: This paper was designed to evaluate a novel surgical procedure of using a gastroduodenal artery graft for reconstruction of the hepatic artery during radical resection of hilar cholangiocarcinoma, which is citation-free and self-contained.In this paper we retrospectively analyzed the clinical data, surgical procedure, and follow-up results in nine patients who underwent hepatic artery reconstruction using a gastroduodenal artery graft during their radical resection of hilar cholangiocarcinoma and no artery thrombosis or other surgical complications were found after operation with minimum follow-up duration of three months.We recommended that a gastroduodenal artery graft was shown to be a good choice for hepatic artery resection after radical resection of hilar cholangiocarcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary Surgery, Hospital & Institute of Hepatobiliary Surgery, PLA General Hospital, Beijing 100853, China.

ABSTRACT
This paper was designed to evaluate a novel surgical procedure of using a gastroduodenal artery graft for reconstruction of the hepatic artery during radical resection of hilar cholangiocarcinoma, which is citation-free and self-contained. In this paper we retrospectively analyzed the clinical data, surgical procedure, and follow-up results in nine patients who underwent hepatic artery reconstruction using a gastroduodenal artery graft during their radical resection of hilar cholangiocarcinoma and no artery thrombosis or other surgical complications were found after operation with minimum follow-up duration of three months. We recommended that a gastroduodenal artery graft was shown to be a good choice for hepatic artery resection after radical resection of hilar cholangiocarcinoma.

No MeSH data available.


Related in: MedlinePlus

The right hepatic artery after bridging reconstruction.
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Related In: Results  -  Collection


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fig4: The right hepatic artery after bridging reconstruction.

Mentions: For the gastroduodenal artery, we, respectively, blocked and cut from the beginning and distal end of the hepatic arteries to the upper edge of the pancreas using a sharp blade and then sutured the ends with a 6-0 Prolene. We placed the cut arterial segments into 4°C heparin (10%) in saline, for backup use after trimming (Figure 2). We trimmed the hepatic artery proximally and distally and blocked it with an artery clamp to prepare the anastomosis under a microscope (Figure 3). First, we anastomosed the distal hepatic artery, fully flushed the arterial lumen with heparin-containing saline, and intermittently anastomosed one artery end with 8-0 Prolene, suturing at 0° and 180°, respectively. For traction, we added a needle between the first two sutures [2]. We flipped the artery after finishing the anterior wall anastomosis and then anastomosed the posterior wall in the same manner. We used the same method to anastomose the other end of the hepatic artery and the artery bridge. During the anastomosis, we ensured that each needle is inserted perpendicularly to penetrate the whole arterial layer to avoid bringing any artery adventitia into the lumen. After completing the anastomosis, we opened the artery clips to check for blood leakage (Figure 4). After surgery, we used conventional low molecular weight heparin (5000 U/day) as an intravenous continuous infusion anticoagulant to prevent the formation of hepatic artery thrombosis. Routine bedside B ultrasound was performed once daily to observe the arterial flow. We also monitored the blood coagulation and blood chemistry testing results. One week after surgery, we reexamined the patient by enhanced abdominal CT. Postoperative follow-up is performed thereafter. The specific surgical artery reconstruction methods are shown in Table 1.


Application of a Gastroduodenal Artery Graft for Reconstruction of the Hepatic Artery during Radical Resection of Hilar Cholangiocarcinoma.

Liang Y, Wang J, Shi X, Dong J, Gu W - Gastroenterol Res Pract (2015)

The right hepatic artery after bridging reconstruction.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4538971&req=5

fig4: The right hepatic artery after bridging reconstruction.
Mentions: For the gastroduodenal artery, we, respectively, blocked and cut from the beginning and distal end of the hepatic arteries to the upper edge of the pancreas using a sharp blade and then sutured the ends with a 6-0 Prolene. We placed the cut arterial segments into 4°C heparin (10%) in saline, for backup use after trimming (Figure 2). We trimmed the hepatic artery proximally and distally and blocked it with an artery clamp to prepare the anastomosis under a microscope (Figure 3). First, we anastomosed the distal hepatic artery, fully flushed the arterial lumen with heparin-containing saline, and intermittently anastomosed one artery end with 8-0 Prolene, suturing at 0° and 180°, respectively. For traction, we added a needle between the first two sutures [2]. We flipped the artery after finishing the anterior wall anastomosis and then anastomosed the posterior wall in the same manner. We used the same method to anastomose the other end of the hepatic artery and the artery bridge. During the anastomosis, we ensured that each needle is inserted perpendicularly to penetrate the whole arterial layer to avoid bringing any artery adventitia into the lumen. After completing the anastomosis, we opened the artery clips to check for blood leakage (Figure 4). After surgery, we used conventional low molecular weight heparin (5000 U/day) as an intravenous continuous infusion anticoagulant to prevent the formation of hepatic artery thrombosis. Routine bedside B ultrasound was performed once daily to observe the arterial flow. We also monitored the blood coagulation and blood chemistry testing results. One week after surgery, we reexamined the patient by enhanced abdominal CT. Postoperative follow-up is performed thereafter. The specific surgical artery reconstruction methods are shown in Table 1.

Bottom Line: This paper was designed to evaluate a novel surgical procedure of using a gastroduodenal artery graft for reconstruction of the hepatic artery during radical resection of hilar cholangiocarcinoma, which is citation-free and self-contained.In this paper we retrospectively analyzed the clinical data, surgical procedure, and follow-up results in nine patients who underwent hepatic artery reconstruction using a gastroduodenal artery graft during their radical resection of hilar cholangiocarcinoma and no artery thrombosis or other surgical complications were found after operation with minimum follow-up duration of three months.We recommended that a gastroduodenal artery graft was shown to be a good choice for hepatic artery resection after radical resection of hilar cholangiocarcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary Surgery, Hospital & Institute of Hepatobiliary Surgery, PLA General Hospital, Beijing 100853, China.

ABSTRACT
This paper was designed to evaluate a novel surgical procedure of using a gastroduodenal artery graft for reconstruction of the hepatic artery during radical resection of hilar cholangiocarcinoma, which is citation-free and self-contained. In this paper we retrospectively analyzed the clinical data, surgical procedure, and follow-up results in nine patients who underwent hepatic artery reconstruction using a gastroduodenal artery graft during their radical resection of hilar cholangiocarcinoma and no artery thrombosis or other surgical complications were found after operation with minimum follow-up duration of three months. We recommended that a gastroduodenal artery graft was shown to be a good choice for hepatic artery resection after radical resection of hilar cholangiocarcinoma.

No MeSH data available.


Related in: MedlinePlus