Evaluation Of Preoperative Bile Duct Drainage And Analysis Of Influencing Factors Of Postoperative Complications In Patients With Hepatic Portal Cholangiocarcinoma

Objective:Through retrospective studies,the efficacy of preoperative biliary drainage in patients with hilar cholangiocarcinoma(HCCA)was evaluated,and the factors affecting the occurrence of postoperative complications in patients were analyzed,hoping to provide some reference for clinical diagnosis and treatment.Methods:Retrospective analysis of clinical data from June 2013 to December 2022 in 81 patients undergoing radical hepatocellular cholangiocarcinoma surgery at The First Affiliated Hospital of Soochow University.The 39 patients who underwent biliary drainage before operation were divided into study groups,and 42 patients who underwent radical hepatocellular carcinoma were divided into control groups to study the effect of preoperative bile duct drainage on radical treatment of hepatocellular carcinoma(HCCA).Risk factors for postoperative complications of hepatocellular cholangiocarcinoma were studied by single and multifactor analysis.Results:(1)There was no significant statistical difference between the study group and the control group in the basic data(sex,age,BMI,history of hypertension,diabetes history)(P>0.05);the preoperative levels of TBil,DBiL,IBiL and AST in the study group were higher than those in the control group,and the level of CA125 was lower than that in the control group(P<0.05);there was no significant difference in the other data indicators of the two groups(P>0.05).(2)After the study group used preoperative bile duct drainage,TBil,DBiL,AST,and ALT decreased significantly compared with preoperative(P<0.05).(3)The duration of surgery in the study group was significantly higher than that in the control group(P<0.05),and there was no significant difference between the amount of intraoperative blood loss and intraoperative blood transfusion between the two groups(P>0.05).(4)Compared with the postoperative liver function and inflammatory indexes of the two groups,the postoperative TBiL and DBiL in the study group were significantly higher than those in the control group(P<0.05).(5)The total length of hospitalization in the study group was significantly higher than that in the control group(P<0.05),and there was no significant difference in the length of postoperative hospitalization between the two groups(P>0.05).(6)There were no significant differences in postoperative complications and secondary surgery between the two groups(P>0.05).(7)Patients with age≤65 years,jaundice duration of≤30 days,and total bilirubin≤200μmol/L were selected,and there were no significant differences between the corresponding patients in the control group in terms of operation time,intraoperative blood transfusion,intraoperative blood loss,postoperative complication rate,secondary operation rate,and postoperative hospitalization length(P>0.05).(8)Univariate and multivariate logistic regression analysis showed that Bismuth classification,operation time and total bilirubin were independent factors influencing the occurrence of postoperative complications.Conclusions:(1)Preoperative biliary drainage can effectively relieve biliary obstruction and improve liver function in patients with hilar cholangiocarcinoma,and have some significance in reducing postoperative complications.(2)For patients with hilar cholangiocarcinoma with younger age,shorter obstruction time,and low preoperative total bilirubin,radical surgery can be performed without preoperative bile duct drainage according to the actual situation of the patient.(3)Bismuth classification,duration of surgery,and total bilirubin were independent factors influencing the occurrence of complications of hilar cholangiocarcinoma.