Application of hemihepatectomy combined with vascular resection and reconstruction in bismuth III and IV hilar cholangiocarcinoma

Objective: This study aims to discuss the applied value of hemihepatectomy in combination with vascular resection and reconstruction in hilar cholangiocarcinoma. Methods: Out of 113 cases of hilar cholangiocarcinoma, 25 cases were classified as Bismuth IIIa, IIIb and IV. Hemihepatectomy in combination with vascular resection and reconstruction was performed by using the basic surgical operation method (A) to achieve radical cure. The following cases were included in this study: 2 cases received A+right hemihepatectomy+pancreatoduodenectomy+resection and reconstruction of the initial part of the right portal vein; 7 cases received A+right hemihepatectomy +resection and reconstruction of the initial part of the right portal vein; 5 cases received A+right hemihepatectomy+resection of the hepatic artery; 3 cases received A+left hemihepatectomy+resection of the left caudate lobe+resection and reconstruction of the initial part of the left portal vein+resection of the hepatic artery; 4 cases received A+left hemihepatectomy+resection of the left caudate lobe; and 4 cases received A+left hemihepatectomy+resection of the caudate lobe+resection and reconstruction of the initial part of the left portal vein. Results: Among the 93 cases of hilar cholangiocarcinoma, the 25 cases with Bismuth IIIa, IIIb and IV hilar cholangiocarcinoma were subjected to hemihepatectomy in combination with vascular resection and reconstruction to achieve radical cure. Postoperative survival rates for one, two, three and five years were 52%, 28%, 12% and 8%, respectively. Conclusion: The combined use of hemihepatectomy and vascular resection and reconstruction could increase the radical resection rate of hilar cholangiocarcinoma