Portal vein stenting in recurrent or locally advanced peri-hilar cholangiocarcinoma

被引：1

作者：

De Bellis, Mario ^{[1
]}

Contro, Alberto ^{[2
]}

Bianco, Andrea ^{[1
]}

Gasparini, Clizia ^{[2
]}

Tripepi, Marzia ^{[1
]}

La Raja, Matilde ^{[2
]}

Alaimo, Laura ^{[1
]}

Conci, Simone ^{[1
]}

Campagnaro, Tommaso ^{[1
]}

Guglielmi, Alfredo ^{[1
]}

Mansueto, Giancarlo ^{[2
]}

Ruzzenente, Andrea ^{[1
,3
]}

机构：

[1] Univ Verona, GB Rossi Univ Hosp, Dept Surg Dent Gynecol & Pediat, Div Gen & Hepatobiliary Surg, P LA Scuro 10, I-37134 Verona, Italy

[2] Univ Verona, GB Rossi Univ Hosp, Dept Diagnost & Publ Hlth, Unit Radiol, P LA Scuro 10, I-37134 Verona, Italy

[3] Univ Verona, Dept Surg Dent Gynecol & Pediat, P LA Scuro 10, I-37134 Verona, Italy

来源：

EJSO | 2024年 / 50卷 / 03期

关键词：

Portal vein stenosis; Portal hypertension; Venous stent; Palliative treatment; Recurrent peri-hilar cholangiocarcinoma; Locally advanced peri-hilar; cholangiocarcinoma; PERIHILAR CHOLANGIOCARCINOMA; VENOUS STENOSIS; PLACEMENT; SURGERY;

D O I：

10.1016/j.ejso.2024.107984

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Recurrent or locally advanced peri-hilar cholangiocarcinoma (PHCC) usually involves the portal vein (PV) leading to significant stenosis. With disease progression, clinical symptoms such as ascites, bleeding, and hepatic insufficiency are usually observed. Little is know about the benefit of PV stenting in relieving the symptoms associated to portal hypertension and allowing anticancer therapies. The aim of this study is to review our experience in PV stenting for PHCC patients. Methods: From 2014 to 2022, data from PHCC patients underwent PV stenting at Verona University Hospital, Italy, were reviewed. The indications were: gastrointestinal bleeding from esophagus-gastric varices, ascites not responsive to medical therapy, severe thrombocytopenia, liver insufficiency (hepatic jaundice, coagulopathy, and/or hyperammoniemia), or asymptomatic high-grade PV stenosis. Cavernous transformation and intrahepatic thrombosis in both sides of the liver were considered contraindication. Systematic anticoagulation therapy was not administered. Results: Technical success was achieved in all 16 (100 %) patients. The improvement of clinical symptoms were observed in 12 (75 %) patients. Anticancer therapy was administrated in 11 (69 %) patients. 2 (13 %) complications were observed: 1 biliary injury and 1 recurrent cholangitis that required a percutaneous trans-hepatic biliary drainage placement. Stent occlusion for tumor progression occurred in 1 patient and a re-stenting procedure was successfully performed. No case of thrombotic stent occlusion was observed during follow up. The 1year stent patency was 86 % and the median patency period was 8 months (IQR, 4-12). Conclusion: PV stenting is a feasible and safe palliative treatment that improves clinical condition, allow anticancer therapies, and provide a better quality of life.

引用

页数：6