A Retrospective Study Of Risk Factors Of Serious Postoperative Complication In Hilar Cholangiocarcinoma

Objective: To investigate the risk factors which influenced the serious postoperative complication of hilar cholangiocarcinoma.Methods: One hundred and four patients with hilar cholangiocarcinoma from 1993.5 to 2007.12 after operation were reviewed retrospectively, of which 66 men and 38 women with the age of 32 to 79 years (57.2±7.9) were included. Of the patients, 31 were underwent radical resection, 28 palliative resection, 45 biliary drainage. Logistic regression test was used to investigate the risk factors of serious postoperative complication in hilar cholangiocarcinoma. Nine factors including sex, age, preoperative jaundice, preoperative albumin, accompanied diseases, liver function classification, operative methods, tumor type and stage were chosen as risk factors.Results: In the study,serious postoperative complications occurred in 30 of 104 patients(28.8%), of which the number of biliary fistula accounted for 30%, bile duct infection for 26.7%, liver failure for 10%, renal failure for 6.7%,intraabdominal bleeding for 6.7%, respiratory failure(with pulmonary infection) for 3.3%, disruption of wound for 16.7%. Univariate analysis showed that 6 factors might influence occurrence of the serious postoperative complication, including age(P=0.000), preoperative jaundice(P=0.001), preoperative ablumin(P=0.000), liver function classification(P=0.001), type of tumor(P=0.048), stage of tumor(P=0.001). In multivariate analysis, however, results showed that 3 factors influenced occurrence of the serious postoperative complication, including age(P=0.000), preoperative jaundice(P=0.001), preoperative ablumin(P=0.000). The serious postoperative complication was positively related to the patient's age and preoperative jaundice, and negatively related to preoperative ablumin. Conclusions: (1) Age, preoperative jaundice and preoperative ablumin were risk factors of serious postoperative complications in hilar cholangiocarcinoma. With the increasing of the patient's age and the degree of preoperative jaundice, decreasing of preoperative ablumin, the risks of serious postoperative complications would rise; (2) Paying attention to the correction of accompanied diseases and pathologic states in aged patients, protecting the liver function and supplying interal and parenteral nutrition perioperatively would decrease the ratio of the serious postoperative complications in hilar cholangiocarcinoma; (3)It is still a dispute whether and when preoperative biliary drainage should be adopted, further researches about how preoperative biliary drainage could influence prognosis and occurrence of the serious postoperative complications in hilar cholangiocarcinoma are needed.