The role of extra-hepatic bile duct resection in the surgical management of gallbladder carcinoma. A first meta-analysis

2021 ◽  
Author(s):  
Tian-Run Lv ◽  
Fei Liu ◽  
Hai-Jie Hu ◽  
Parbatraj Regmi ◽  
Wen-Jie Ma ◽  
...  
Keyword(s):  
Bile Duct ◽  
Surgical Management ◽  
Gallbladder Carcinoma ◽  
Meta Analysis ◽  
Bile Duct Resection ◽  
Hepatic Bile ◽  
Hepatic Bile Duct

scholarly journals Is combined extra-hepatic bile-duct resection justified for advanced gallbladder carcinoma?

2019 ◽  
Vol 7 (6) ◽  
pp. 426-433 ◽  
Author(s):  
Jun-Ke Wang ◽  
Wen-Jie Ma ◽  
Zhen-Ru Wu ◽  
Qin Yang ◽  
Hai-Jie Hu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Bile Duct ◽  
Lymph Node Metastasis ◽  
Gallbladder Carcinoma ◽  
Curative Surgery ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Resection Group ◽  
Node Metastasis ◽  
T Category

Abstract Background Whether the extra-hepatic bile duct (EHBD) should be routinely resected for gallbladder carcinoma (GBC) remains controversial. The current study aimed to determine the clinical impact of combined EHBD resection during curative surgery for advanced GBC. Methods In total, 213 patients who underwent curative surgery for T2, T3 or T4 GBC were enrolled. The clinicopathological features were compared between the patients treated with EHBD resection and those without EHBD resection. Meanwhile, univariable and multivariable Cox-proportional hazards regression models were used to identify risk factors for overall survival (OS). Results Among the 213 patients identified, 87 (40.8%) underwent combined EHBD resection. Compared with patients without EHBD resection, patients with EHBD resection suffered more post-operative complications (33.3% vs. 21.4%, P = 0.046). However, the median OS of the EHBD resection group was longer than that of the non-EHBD resection group (25 vs. 11 months, P = 0.008). Subgroup analyses were also performed according to tumor (T) category and lymph-node metastasis. The median OS was significantly longer in the EHBD resection group than in the non-EHBD resection group for patients with T3 lesion (15 vs. 7 months, P = 0.002), T4 lesion (11 vs. 6 months, P = 0.021) or lymph-node metastasis (12 vs. 7 months, P < 0.001). No survival benefit of EHBD resection was observed in GBC patients with T2 lesion or without lymph-node metastasis. T category, lymph-node metastasis, margin status, pre-operative CA19-9 level and EHBD resection were identified as independent prognostic factors for OS of patients with advanced GBC (all P values <0.05). Conclusions EHBD resection can independently affect the OS in advanced GBC. For GBC patients with T3 lesion, T4 lesion and lymph-node metastasis, combined EHBD resection is justified and may improve OS.

Routine extra-hepatic bile duct resection in gallbladder cancer patients without bile duct infiltration: A systematic review

The Surgeon ◽  
2016 ◽  
Vol 14 (6) ◽  
pp. 337-344 ◽  
Author(s):  
Giuseppe Nigri ◽  
Giammauro Berardi ◽  
Chiara Mattana ◽  
Livia Mangogna ◽  
Niccolò Petrucciani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bile Duct ◽  
Gallbladder Cancer ◽  
Cancer Patients ◽  
Bile Duct Resection ◽  
Hepatic Bile ◽  
Hepatic Bile Duct

Extra-Hepatic Bile Duct Resection: an Insight in the Management of Gallbladder Cancer

2015 ◽  
Vol 46 (3) ◽  
pp. 291-296 ◽  
Author(s):  
Durgatosh Pandey ◽  
Pankaj Kumar Garg ◽  
N. M. L. Manjunath ◽  
Jyoti Sharma
Keyword(s):  
Bile Duct ◽  
Gallbladder Cancer ◽  
Bile Duct Resection ◽  
Hepatic Bile ◽  
Hepatic Bile Duct

scholarly journals Extraluminal recanalization for postoperative biliary obstruction using transseptal needle

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Horinouchi ◽  
Eisuke Ueshima ◽  
Keitaro Sofue ◽  
Shohei Komatsu ◽  
Takuya Okada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Biliary Obstruction ◽  
Hepatic Duct ◽  
Drainage Tube ◽  
Biliary Strictures ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Benign Biliary Strictures ◽  
The Right

Abstract Background Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle. Case presentation A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal–external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma. Conclusions Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.

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