| Objective:To analyse the efficacy and safety of caudate lobectomy in the treatment of hilar cholangiocarcinoma.Methods:A thorough search of Pubmed,Embase,the Cochrane library and the Chinese Bio Medical Literature(CBM)databases was performed to identify comparative studies concerning combined caudate lobe resection versus lobectomy without caudate lobe resection in the treatment of HCCA.Results:six studies with a total of 658 HCCA cases statisfied the inclusion criteria.The results of the meta-analysis revealed that CL was associated with a better overall survival than without CL(HR=2.29;95%CI 1.89~2.79;P<0.00001); Besides,dispite of the comparable proportion of lymph node metastasis(OR=0.74;95%CI 0.41~1.34;P=0.32) or perineural invasion(OR=0.81;95%CI 0.48~1.36;P=0.42)between two groups,the CL group exhibited significantly higher rates of R0 resection(OR=6.37;95%CI 3.88~10.46;P<0.00001).No significant differences were found between the two groups in respect to postoperative mortality and morbidity.Conclusions:Combined CL which can benefit the overall survival in certain patients is safe and feasible in the treatment of HCCA.However,further randomized contralled trails are necessary to determine the prognostic effects of the additon of CL as a conventional surgical procedure. |
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