Clinic Characteristics And Treatment Of Hilar Cholangiocarcinoma

Objective: Through the analysis of clinical characteristics,laboratory tests,imaging,treatment,pathology,complications,and prognosis indicators of hilar cholangiocarcinoma,in order to improve the earlier diagnosis rate of such patients and provide a reliable basis for clinical treatment,and reduce the rate of postoperative complications and improve the prognosis.At the same time explore the effects of different surgical treatments for prognosis.Methods: By collecting 38 patients confirmed by pathology hilar cholangiocarcinoma from 2006 Month –to January 2016 period in our hospital.Through the retrospective analysis of the clinical data and telephone interviews,collecting the living conditions of the patients.At the same time to classify respectively the date based on the surgical treatment(no resection of patients with biliary-enteric anastomosis stent drainage,T tube drainage,PTCD external drainage),the radical group(R0),palliative group(R1,R2),drainage group.?2 test and Fisher exact test to compare count data,Kaplan-Meier survival rate calculated for each group,and the survival curve is plotted,with log-rank univariate analysis of survival in each group whether the difference,P <0.05 was considered statistically significant.Result:(1)In the 38 cases,progressive painless skin stained yellow in 34 cases(89.5%),with itching in 26(68.4%),occasional abdominal pain and discomfort come to get treatment in 10 patients(26.3%),fever 2 cases(5.3%),the average time was 20 days;laboratory tests were elevated total bilirubin,which direct bilirubin,and GGT,ALP,CA19-9 varying degrees increased,CEA of 10 cases grow higher;The diagnosis was 18.7% by B-ultrasound of 22 cases,The diagnosis was 86.7% by CT examination in 33 cases,the diagnosis was 96.5% by MRI and MRCP examination in 31 cases,.CT and MRI + MRCP are the main objective on the basis of pre-hilar cholangiocarcinoma diagnosis.(2)The group of case,the radical resection rate was 39.4%,the median survival time was 20 months,the time of radical surgery survival was significantly better than the palliative and drainage(P <0.05),three different treatments have significant differences between each other.(3)Four kinds of clinical typing,the rate of radical resection of type ??? patients is higher than ?? ? type patients(P <0.05),??? type have a higher proportion of external drainage treatment(P <0.05);The three clinical staging,T1?T2 implementation of radical surgery is higher than the proportion of patients with T3(P <0.05),T3 patients have a high proportion of external drainage treatment(P <0.05).The three TNM staging,?? ? implement radical resection is higher than the proportion of patients with stage ?(P <0.05),stage ? were treated with a high proportion of external drainage treatment(P <0.05).Of the three pathological type,the high grade group underwent radical resection or palliative surgery is higher than the proportion of patients with poor differentiation(P <0.05),and patients with poorly differentiated BOC drainage than the other components of the pathological type(P < 0.05).Conclusion:1.As the unconspicuous of hilar cholangiocarcinoma,radical resection rate has been low after diagnosis2.The imaging is the primary means of the diagnosis of hilar cholangiocarcinoma3.Hilar cholangiocarcinoma radical resection relate to clinical type,Blumgart stage,TNM stage,degree of pathological differentiation 4.Radical resection can significantly prolong the survival time of patients5.Multi-disciplinary cooperation,MDT,accurate medical improvement will facilitate the diagnosis and treatment of hilar cholangiocarcinoma,improve the rate of treatment...