Abstract:Objective:To explore the factors related to effects and prognosis of surgical treatment of hilar cholangiocarcinoma.
Methods :The clinical data of 41 patients with hilar choIangiecarcinoma (HCCA) admitted in recent seven years were investigated and anlyzed retrospectively.
Results:Among 41 patients with HCCA,the accuracy rate of diagnosis by imaging technology was 95.1% before operation. Thirty-two cases were treated by surgical resection, of which 15 cases had radical resection and 17 cases had palliative resection, the total resection rate was 78.1%, and 9 cases had biliary internal drinage procedure. Two cases died during hospitilization. The rate of one-,three-and five-year survival for surgical resection was 70.0%，40.0% and 23.3％ respectively,and for palliation drainage was 44.4%，11.1%，and 0%, respectively.The median survial time was 28 months and 8 months for surgical resction and palliation drainage, respectively.The difference between surgical resction and palliation drainage on survival rate and median survival time was signigicant (P<0.05 and P<0.05 respectively).In 14 of the cases were treated with R0, the 1-,3-and 5-year survival rate and median survival time was 85.7%、64.3%、35.7% and 52 months respectively; and different rank of operation had different curative effects(P<0.05).Acording to Bismuth type,type II had a the higher survival with 1-,3-and 5-year survival rate and median survival time of 85.7%、71.4%、42.9% and 72 months respectively. The resection rate for papillary and highly differentiated adenocarcinoma was 77.8% and 78.3%, respectively, and the 1-,3-and 5-year survival rate was 77.8%, 44.4%,33.3%,and 73.9%,65.2% 17.4%, respectively; while it was 20%, 0% and 0% respectively for low differentiated carcinoma.Conclusions:The curative efficacy of surgery and postoperative prognosis of HCCA depend largely on different clinical characteristics, pathological type and surgical method. Radical resection plays a key role to improve long-term survival.