Analysis Of Laparoscopic And Open Radical Resection For Hilar Cholangiocarcinoma Of Type Bismuth-?

Objective: To investigate the clinical effect of laparoscopic and open radical resection of hilar cholangiocarcinoma(Bismuth-?)Methods: From January 2011 to January 2017,The clinical data of 34 patients with Bismuth-? type hilar cholangiocarcinoma underwent surgical treatment in the Department of hepatobiliary surgery of the Second Affiliated Hospital of Nanchang University,including 10 cases of laparoscopic surgery and 24 cases of open surgery.Results: The two groups of patients with Bismuth-? hilar cholangiocarcinoma performed radical resection was successfully.The volume of blood loss(179.50±98.05)ml and duration of hospital stay(11.80±2.49)days of laparoscopic group lower than(261.25±97.33)ml?(16.25±3.35)days of open group(p<0.05).The levels of Tbil of laparoscopic group at days after operation 1,3,5 were(102.20±45.49)mmol/L,(83.57±30.66)mmol/L,(45.09±18.41)mmol/L.The levels of Tbil of open group at days after operation 1,3,5 were(102.20±45.49)mmol/L,(83.57±30.66)mmol/L,(45.09±18.41)mmol/Land the difference was statistically significant(p<0.05).And the laparoscopic group postoperative number of lymph nodes dissected 9.79±3.05,postoperative complications 1 cases,positive margin 0 cases;and open group number of lymph nodes9.30±3.06,postoperative complications 3 cases and Positive margin of bile duct 0 cases,had no statistically significant differences were compared(p>0.05).Two groups of patients were followed up for 6~18 months by telephone,outpatient and other means,and no recurrence and metastasis were found in the two groups during the follow-up period.Conclusion: Laparoscopic radical resection for hilar cholangiocarcinoma in Bismuth-? is similar to open Bismuth-? hilar cholangiocarcinoma in lymph node dissection,postoperative complications,positive margins,prognosis during follow-up and more minimally invasive advantages.Therefore,Under strict selection of appropriate cases,laparoscopic radical resection for hilar cholangiocarcinoma of type Bismuth-? is safe and feasible.