Clinical Effect Analysis Of Hyperthermic Intraperitoneal Chemotherapy After Gallbladder Carcinoma Resection

BackgroundSurgery is the only radical treatment for gallbladder carcinoma,but after surgical treatment,the recurrence and metastasis rate is high.There are few studies on the efficacy of Hyperthermic intraperitoneal chemotherapy（HIPEC）after gallbladder carcinoma resection,such as whether it can quickly improve liver and kidney function,reduce postoperative recurrence rate and adverse reactions,and improve patient survival prognosis.There is no clear evidence of clinical efficacy of Hyperthermic intraperitoneal chemotherapy after gallbladder carcinoma resection.In the study and analysis of this paper,the clinical effect and short-term survival of Hyperthermic intraperitoneal chemotherapy after gallbladder carcinoma resection will be further clarified,so as to provide a basis for the application of Hyperthermic intraperitoneal chemotherapy in gallbladder carcinoma.ObjectiveTo evaluate the short-term effect of Hyperthermic intraperitoneal chemotherapy after gallbladder carcinoma resection by retrospective analysis.To provide basis for its application in gallbladder carcinoma.MethodsThe general data of patients with highly suspected gallbladder cancer undergoing surgery（gallbladder resection）in the first Department of general surgery（hepatobiliary pancreatic surgery）of the First Affiliated Hospital of Xinxiang Medical university from August 2018 to February 2021 were collected and statistically analyzed.The experimental group,namely the operation+HIPEC group,underwent abdominal thermoperfusion chemotherapy after surgery;The control group,namely the operation group,did not receive intraperitoneal thermal perfusion chemotherapy after surgery.General clinical data,such as gender,age and concomitant cholecystolithiasis,were recorded.The changes of liver and kidney function indexes on postoperative day 1,postoperative day 3 and postoperative day 6were compared between the two groups.The pathological features,adverse reactions and complications of the two groups were recorded.Patients’survival status and whether metastasis or recurrence were known through telephone follow-up or outpatient review.Follow up endpoint was February 2022 or the death of patients during this period.Results1.There were 16 patients in the surgery+HIPEC group and 19 patients in the surgery group;There were no significant differences in gender,age and combined calculi between the two groups（P>0.05）.2.There was no statistical significance in pathological classification,tumor size,tumor differentiation degree,lymph node metastasis and nerve invasion between the two groups（P>0.05）.3.The liver and kidney function indexes of the two groups on the first day,the third day and the sixth day after operation were compared,which showed that there was no significant difference in the levels of liver function（ALT,AST,TBIL,DBIL）and renal function（Cr,BUN）indexes between the two groups（P>0.05）.There was no significant difference in postoperative adverse reactions and complications between the two groups（P>0.05）.4.The comparison of postoperative adverse reactions and complications between the two groups showed that the overall incidence of adverse reactions and complications in the operation+HIPEC group was lower than that in the operation group,with statistical significance（P<0.05）.5.Postoperative survival analysis:the 3-month survival rate was 100%in the operation+HIPEC group and 94%in the operation group;The 6-month survival rate of the operation+HIPEC group was 100%,which was significantly higher than that of the operation group（68.4%）.The 6-month survival rate of the operation+HIPEC group was significantly higher than that of the operation group（P<0.05）,which was statistically significant.The median follow-up time of the surgery+HIPEC group was（12.9±1.09months）,and that of the surgery group was（9.0±0.99 months）;The log-rank method was used to compare the survival difference between the two groups,and theχ~2value=11.156,P=0.001<0.05,indicating that there was a significant difference in survival between the two groups.The survival time of the combined intraperitoneal heat perfusion chemotherapy group was significantly longer than that of the surgical treatment group.Conclusions（1）Hyperthermic intraperitoneal chemotherapy after gallbladder carcinoma resection is safe and feasible,and can reduce the overall incidence of adverse reactions and complications in patients;（2）Hyperthermic intraperitoneal chemotherapy after gallbladder carcinoma resection can prolong the postoperative survival time of patients.