Application of Anatomy of the Caudal Branch of the Portal Vein in Surgery of Hilar Cholangiocarcinoma

Zhong Haoliang; Song Denghui

doi:10.3969/j.issn.1004-5775.2025.24.015

Abstract：Objective:The anatomical technique of the caudate lobe branch of the portal vein was applied in the surgery of hilar non-cholangiocarcinoma,aiming to evaluate its application effect.Methods:A total of 100 patients with portal cholangiocarcinoma admitted to Zhumadian Central Hospital from January 2019 to March 2022 were selected as the subjects.After randomly generating sequences using the computer randomization method,the subjects were equally distributed to the conventional group(n=50)and the caudate lobe group(n=50).The conventional group received conventional radical surgery,while the caudate lobe group received resection assisted radical surgery based on portal vein caudate branch dissection technology.All patients were followed up for two years after treatment,and the treatment status,liver function indicators,postoperative complications,and survival of the two groups of patients were compared.Results:Under different treatment regimens,the surgical time,intraoperative blood loss,and hospital stay in the caudate lobe group were compared with the conventional group,with no statistically differences(P＞0.05);the R0 resection rate and postoperative future liver remnant/standard liver volume(FLV/SLV)were higher than the conventional group,and the differences were statistically significant(P＜0.05);alanine aminotransferasealt(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),and total bilirubin(TBil)in the caudate lobe group were lower than the conventional group,and the differences were statistically significant(P＜0.05);the incidence of postoperative complications in the caudate lobe group(6%)was lower than the conventional group(24%),and the differences were statistically significant(P＜0.05).The progression-free survival rate(PFS),overall survival rate(OS),median PFS and median OS at the end of follow-up in the caudate lobe group were higher than those in the conventional group,and the differences were statistically significant(P＜0.05).Conclusion:The anatomical technique of the caudate branch of the portal vein assisted radical surgery for hilar cholangiocarcinoma can optimize the surgical efficacy of patients,reduce intraoperative bleeding,improve postoperative liver function,reduce the risk of complications,and prolong survival.