Scholarlink

Background <p>Right-sided hepatectomy (RH) is the standard surgical approach for perihilar cholangiocarcinoma (PHC) due to anatomical considerations but is associated with a high risk of post-hepatectomy liver failure (PHLF). Left-sided hepatectomy (LH) and central hepatectomy (CH) have been proposed as alternative strategies to preserve liver function, but the feasibility and outcomes of CH have not been sufficiently investigated. CH allows for greater preservation of liver parenchyma, potentially reducing the risk of PHLF.</p> Methods <p>This retrospective study analyzed 63 patients with PHC who underwent major hepatectomy at the Juntendo University Hospital between January 2019 and March 2024. Patients were categorized into the LH (<i>n</i>&#xa0;=&#xa0;18), RH (<i>n</i>&#xa0;=&#xa0;28), and CH (<i>n</i>&#xa0;=&#xa0;17) groups. Preoperative future liver remnant volume, perioperative outcomes, pathological findings, and long-term outcomes were compared. Statistical significance was set at <i>p</i>&#xa0;&lt;&#xa0;0.05.</p> Results <p>The CH group had a significantly higher future liver remnant volume compared with the RH group (62.7% vs. 45.5%; <i>p</i>&#xa0;&lt;&#xa0;0.001). The incidence of PHLF was lower in CH (11.8%) than RH (39.3%), although not statistically significant. CH was associated with a longer median operative time (691&#xa0;min) and a higher incidence of bile leakage (47.1%). R0 resection rates and long-term outcomes were comparable among the three groups.</p> Conclusions <p>CH is a feasible alternative in selected PHC, offering comparable oncological outcomes while preserving functional liver volume despite its technical complexity.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Central Hepatectomy as an Alternative: A Comparative Study with Conventional Major Hepatectomy for Perihilar Cholangiocarcinoma

  • 期刊论文

  • 发表日期：

    2025年9月8日

查看全文
  • Masahiro Fujisawa,
  • Ryuji Yoshioka,
  • Atsushi Takahashi,
  • Yoshinori Takeda,
  • Shoichi Irie,
  • Hirofumi Ichida,
  • Yoshihito Kotera,
  • Yoshihiro Mise,
  • Akio Saiura

摘要

Background

Right-sided hepatectomy (RH) is the standard surgical approach for perihilar cholangiocarcinoma (PHC) due to anatomical considerations but is associated with a high risk of post-hepatectomy liver failure (PHLF). Left-sided hepatectomy (LH) and central hepatectomy (CH) have been proposed as alternative strategies to preserve liver function, but the feasibility and outcomes of CH have not been sufficiently investigated. CH allows for greater preservation of liver parenchyma, potentially reducing the risk of PHLF.

Methods

This retrospective study analyzed 63 patients with PHC who underwent major hepatectomy at the Juntendo University Hospital between January 2019 and March 2024. Patients were categorized into the LH (n = 18), RH (n = 28), and CH (n = 17) groups. Preoperative future liver remnant volume, perioperative outcomes, pathological findings, and long-term outcomes were compared. Statistical significance was set at p < 0.05.

Results

The CH group had a significantly higher future liver remnant volume compared with the RH group (62.7% vs. 45.5%; p < 0.001). The incidence of PHLF was lower in CH (11.8%) than RH (39.3%), although not statistically significant. CH was associated with a longer median operative time (691 min) and a higher incidence of bile leakage (47.1%). R0 resection rates and long-term outcomes were comparable among the three groups.

Conclusions

CH is a feasible alternative in selected PHC, offering comparable oncological outcomes while preserving functional liver volume despite its technical complexity.