Surgical Diagnosis And Treatment Of Hilar Cholangiocarcinoma

Objective:This paper discusses the diagnosis, surgical treatment and clinical effectwith hilar cholangiocarcinoma, In order to further understanding of this disease.Method:Retrospective collect35clinical datas from2008to2013in First AffiliatedHospital of Fujian Medical University which were diagnosised by pathological andtreated for hilar cholangiocarcinoma, and follow-up their postoperative survival time.Results:The group collects35clinical datas of hilar cholangiocarcinoma. Theinclusion criteria is pathological diagnosis clearly and support with auxiliaryexamination such as B ultrasound, CT, MRI or MRCP. There are19males and16females. The mainly clinical manifestations: upper abdominal pain, pruritus, Jaundice,nausea, chills and fever. Alpha fetoprotein is in the normal range, carbohydrateantigen199increased in30cases, carbohydrate antigen125increased in8cases. Bultrasound, CT, MRI show that patients with different levels of intrahepatic bile ductdilatation or hepatic portal echo mass. Intraoperative exploration according toimproved Bismuth-Corlette clinical classification method, I type1case, II type9cases, IIIa type6cases, IIIb type6cases, IV type case13cases. In35cases, all ofthem were accepted surgery,13cases (37.14%) were accepted radical resection (R0resection),13cases (37.14%) were accepted palliative resection and9cases (25.72%)were accepted simple biliary drainage. In the surgical group, there are5cases sufferedthe serious surgical complications.12cases are followed up for radical resection,1,2,3years survival rate are83.33%,66.67%,33.33%, and the average survival time is(34.7±4.8) months;12cases are followed up for palliative resection,1,2,3yearssurvival rate are50.00%,25.00%,0%, and the average survival time is (21.2±3.8)months;9cases are followed up for simple biliary drainage,1,2,3years survival rateare11.11%,0%,0%, and the average survival time is (7.0±1.1) months. The differentsurvival rates of two years and three years between radical resection group andpalliative resection group was statistically significant, and the survival time among the three groups have statistically significant differences (p <0.05).Conclusion: Surgery is still the key to the treatment of hilar cholangiocarcinoma,Radical resection can make patient get longer survival time. Hilarcholangiocarcinoma often has unspecific clinical manifestations in the early, althoughit isn’t difficult to diagnose when the patient have Jaundice, but most have beenadvanced tumor. Medical imaging is contributes to diagnose hilar cholangiocarcinomain the early. So, if someone is suspected of hilar cholangiocarcinoma, it’s good forhim to make medical imaging as soon as early, in order to improve radical resectionrate.