Clinical role of splenic artery ligation in hilar cholangiocarcinoma undergoing major hepatic resection

doi:10.3877/cma.j.issn.1674-0793.2024.04.006

Abstract

Abstract:

Objective

To investigate the clinical effect of splenic artery ligation in patients with hilar cholangiocarcinoma (HCCA) undergoing major liver resection (MLR).

Methods

Twenty-two patients admitted to the First Affiliated Hospital of Bengbu Medical College from July 2021 to June 2023 with HCCA undergoing MLR alone were selected as the control group, and twelve patients undergoing MLR combined with splenic artery ligation (SAL) were selected as the trial group. The preoperative and postoperative clinical data of white blood cell count, platelet count, transaminases, total bilirubin (TB), albumin (ALB), international normalized ratio (INR), and postoperative complications in both groups were analyzed.

Results

The preoperative counts of white blood cell and platelet in the trial group were not statistically significant compared with those at discharge, indicating that splenic artery ligation did not affect spleen function. The trial group had better INR, TB, drainage flow, Clavien-Dindo grade Ⅲ-Ⅴpostoperative complications, postoperative hospital days, and total costs than those of the control group on the 5th postoperative day (P<0.05).

Conclusion

Combining SAL with MLR in patients with HCCA is safe and effective, and it is important to reduce serious postoperative complications and shorten the postoperative recovery period.

Key words: Splenic artery ligation, Bile duct neoplasms, Hilar cholangiocarcinoma, Major liver resection

Nan Xu, Yunchuan Yang, Chi Zhou, Xiang Ma, Zheng Lu, Peiyuan Cui. Clinical role of splenic artery ligation in hilar cholangiocarcinoma undergoing major hepatic resection[J]. Chinese Archives of General Surgery(Electronic Edition), 2024, 18(04): 271-274.

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Figures/Tables 9

References 16

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组别	例数	年龄(岁)^a	性别(例,男/女) ^b	肿瘤直径(cm) ^a	总胆红素(μmol/L) ^a	丙氨酸转氨酶(U/L) ^c	天冬氨酸转氨酶(U/L) ^c
试验组	12	60.00±8.15	5/7	3.03±0.93	36.79±18.71	35.50(27.25,44.00)	42.00(38.00,57.00)
对照组	22	65.09±8.61	14/8	2.44±1.13	43.91±8.03	43(15.50,82.00)	40.50(22.75,70.50)
统计值		-1.688	-	1.539	-1.562	-0.379	-0.848
P值		0.103	0.288	0.133	0.130	0.705	0.397
组别	白蛋白(g/L) ^a	Child-Pugh分级^a	白细胞计数(×10⁹/L) ^a	血小板计数(×10⁹/L) ^a	国际标准化比值^a	伴有慢性疾病^d
试验组	37.64±4.70	5.91±1.08	5.83±1.57	207.25±65.34	1.09±0.30	8(75.0)
对照组	39.59±3.43	6.05±0.49	6.97±2.74	234.23±65.36	0.97±0.08	16(72.7)
统计值	-1.386	-0.524	-1.324	-1.150	1.784	-
P值	0.174	0.605	0.196	0.259	0.084	0.714

组别	例数	年龄(岁)^a	性别(例,男/女) ^b	肿瘤直径(cm) ^a	总胆红素(μmol/L) ^a	丙氨酸转氨酶(U/L) ^c	天冬氨酸转氨酶(U/L) ^c
试验组	12	60.00±8.15	5/7	3.03±0.93	36.79±18.71	35.50(27.25,44.00)	42.00(38.00,57.00)
对照组	22	65.09±8.61	14/8	2.44±1.13	43.91±8.03	43(15.50,82.00)	40.50(22.75,70.50)
统计值		-1.688	-	1.539	-1.562	-0.379	-0.848
P值		0.103	0.288	0.133	0.130	0.705	0.397
组别	白蛋白(g/L) ^a	Child-Pugh分级^a	白细胞计数(×10⁹/L) ^a	血小板计数(×10⁹/L) ^a	国际标准化比值^a	伴有慢性疾病^d
试验组	37.64±4.70	5.91±1.08	5.83±1.57	207.25±65.34	1.09±0.30	8(75.0)
对照组	39.59±3.43	6.05±0.49	6.97±2.74	234.23±65.36	0.97±0.08	16(72.7)
统计值	-1.386	-0.524	-1.324	-1.150	1.784	-
P值	0.174	0.605	0.196	0.259	0.084	0.714

时间	白细胞计数	血小板计数
术前	5.83±1.57	207.25±65.34
出院时	6.83±1.63	169.75±69.31
t值	-1.531	1.355
P值	0.140	0.186

时间	白细胞计数	血小板计数
术前	5.83±1.57	207.25±65.34
出院时	6.83±1.63	169.75±69.31
t值	-1.531	1.355
P值	0.140	0.186

组别	例数	手术时长(min)^a	术中出血量(ml)^b
试验组	12	387.42±77.62	600(525, 1 000)
对照组	22	412.32±96.55	500(400, 1 200)
统计值		-0.770	-1.273
P值		0.449	0.204

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