The Diagnosis And Treatment Of Hilar Cholangiocarcinoma

PurposeThe clinical data of hilar cholangiocarcinoma treated in Henan Provincial people’s Hospital were analyzed,and the early diagnosis and treatment of hilar cholangiocarcinoma were discussed in order to provide valuable reference for the diagnosis and treatment of this disease.MethodsA retrospective analysis was conducted in 38 patients with hilar cholangiocarcinoma from April 2013 to February 2018.The included data included patient history,major clinical manifestations,liver function,tumor-related markers,treatment methods,postoperative pathological reports and survival status of patients followed up,as well as imaging examination(B-ultrasound CT MRI,etc.)SPSS software was used for statistical analysis.Results:1.Of the 38 cases of hilar cholangiocarcinoma,26 cases were aged over 45 years,and 26 cases were over 68.42 years of age,and the most of them were 68.42 cases of cholangiocarcinoma aged 61～70 years.The most of them were 39.47 cases of cholangiocarcinoma aged 61～70 years.2.There were 13 cases of radical resection(type Ⅰ in 3 cases,type Ⅱ in 5 cases,typeⅢ a in 2 cases,type Ⅲ b in 3 cases,palliative resection in 8 cases).Simple choledochoj ej unostomy was performed in 4 cases,percutaneous transhepatic choledochotomy in 10 cases and conservative treatment in 3 cases.3.postoperative pathology:among 21 cases of postoperative pathology,18 cases of bile duct adenocarcinoma,3 cases of adenosscale carcinoma of the bile duct,6 cases of highly differentiated adenocarcinoma,8 cases of differentiated adenocarcinoma,4 cases of3 low differentiated adenocarcinoma in.5,and 4 cases of lymph node metastasis.4.Postoperative complications included biliary leakage in 7 cases,subseptal infection in 4 cases,incision infection in 3 cases,gastrointestinal bleeding in 3 cases,and pulmonary infection in 2 cases(2 cases)with liver failure after radical resection.There was no clinical death.5.The 1-year,2-year and 3-year survival rates of radical resection group were 61.54 and 38.460.38,those of palliative resection group were 25.0012.50%and 0,respectively,and that of internal and external drainage group were 21.42%and 0%,respectively.In this study,there was a significant difference in curative effect between the radical operation group and the latter two groups(P<0.05).Conclusions1.Middle and old people are susceptible to hilar cholangiocarcinoma.The possibility of this disease should be considered in men with progressive obstructive jaundice.Patients with chronic cholangitis and calculi should be on guard against this disease.2.There is no specific tumor marker in the cholangiocarcinoma.The combined detection of CA 19-9 and CEA can improve the positive diagnosis rate of cholangiocarcinoma,and the diagnostic value of CT and MRI is better than that of B ultrasound.3.Radical resection is the best treatment for hilar cholangiocarcinoma.This is also a key factor in improving the patient’s long-term survival.Drainage therapy can relieve the symptoms of biliary obstruction,improve liver function and prolong survival time.