Right Hepatic Artery Interruption And Prostaglandin E-1 In Total Or Proximal Pancreatectomy For Pancreatobiliary Malignancy

Background/Aims: Advanced hepato-biliary-pancreatic malignancy can frequently involve the hepatic artery. We evaluated the use of prostaglandin E-1 in total or Proximal Pancreatectomy with the right hepatic artery interruption.Methodology. A Consecutive seven of 117 patients (6.0%) in whom the right hepatic artery was interrupted and not reconstructed were reviewed retrospectively. Four of them received prostaglandin E-1 (10-20ng/kg/min) until the fifth postoperative day, while, the remaining three did not. The effect of prostaglandin E-1 was compared concerning complication and hepatic function.Results: The right hepatic artery was intentionally resected because of cancer invasion in five patients with biliary tract carcinoma, while, accidentally transected in two with pancreatic carcinoma. Operative deaths did not occur. The biliary leakage was identified in one patient treated without prostaglandin E-1. Although a marked rise in glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, and lactate dehydrogenase levels was observed, hepatic dysfunction was successfully treated conservatively in all patients. The glutamic oxaloacetic transaminase and lactate dehydrogenase values were significantly lower (P <0.05) in patients treated with prostaglandin E-1 compared with those without prostaglandin E-1.Conclusions: The prostaglandin E-1 infusion can be helpful for biliary anastomosis and hepatic function in radical hepato-biliary-pancreatic surgery with the right hepatic artery interruption.