Abstract
We reviewed our experience of surgical treatment for hepatobiliary and pancreatic carcinomas with reconstruction of portal vein (PV) in the period of the last 21 years. and evaluated the indications and the problem. From April, 1980 to May, 2000, 48 of 425 patients underwent PV reconstruction. Resection of PV tumor-thrombi and PV reconstruction were performed in 7 of 295 hepatectomies for hepatocellular carcinoma (HCC). Transcatheter arterial embolizadon (TAE) or re-resection for HCC in the remnant liver was added in 3 of the 7 patients. PV reconstruction included cholangiocellular carcinoma (CCC) in 8 of 28 cases (29%), biliary tract carcinoma in 16 of 68 cases (24%), and pancreatic carcinoma in 17 of 34 cases (50%). There were no significant differences in cumulative survival rates between the patients with and without PV reconstruction in resection of biliary tract and pancreatic carcinomas. Early PV stenosis occurred because of intra-abdominal infection in 3 of 48 cases, but there were no severe complications in them.
PV tumor thrombectomy and PV reconstruction were useful in patients with advanced HCC, and led to treat of HCC in the remnant liver and improve the prognosis. In the biliary tract and pancreatic carciomas, PV reconstruction is expected to increase the resection rates and curability and improve significantly prognosis of pv0~1 patients.
