Right hepatic artery interruption and prostaglandin E-1 in total or proximal pancreatectomy for pancreatobiliary malignancy

Background/Aims: Advanced hepato-biliary-pancreatic malignancy can frequent ly involve the hepatic artery. We evaluated the use of prostaglandin E-1 in total or Proximal Pancreatectomy with the right hepatic artery interruptio n. Methodology. A Consecutive seven of 117 patients (6.0%) in whom the right h epatic artery was interrupted and not reconstructed were reviewed retrospec tively. 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 can cer invasion in five patients with biliary tract carcinoma, while, accident ally transected in two with pancreatic carcinoma. Operative deaths did not occur. The biliary leakage was identified in one patient treated without pr ostaglandin E-1. Although a marked rise in glutamic oxaloacetic transaminas e, glutamic pyruvic transaminase, and lactate dehydrogenase levels was obse rved, hepatic dysfunction was successfully treated conservatively in all pa tients. The glutamic oxaloacetic transaminase and lactate dehydrogenase val ues were significantly lower (P <0.05) in patients treated with prostagland in E-1 compared with those without prostaglandin E-1. Conclusions: The prostaglandin E-1 infusion can be helpful for biliary anas tomosis and hepatic function in radical hepato-biliary-pancreatic surgery w ith the right hepatic artery interruption.