| Objective: To investigate clinical efficacy of limited hepatectomy and extended hepatectomy for hilar cholangiocarcinoma(HCCA)of Bismuth-Corlette type Ⅲ and Ⅳ.Methods: Clinical data of 61 patients with HCCA of Bismuth-Corlette type Ⅲ and Ⅳ admitted in Department of hepatobiliary surgery of First Affiliated Hospital of Bengbu Medical College from January,2008 to May,2015 were analyzed retrospectively.Among 61 cases,for group of extended hepatectomy,22 underwent hepatectomy with half or more than half of liver removed or/and hepatic caudate lobectomy while for limited hepatectomy group,39 cases underwent irregular hepatectomy on hepatic hilar region.Results: By comparing ALT,AST and TB one week before and after the surgery,differences were statistically significant(both P<0.05).The decrease of ALT,AST,TB and ALB between two groups one week before and after the surgery was not significantly different(both P>0.05).Compared with group of limited hepatectomy,patients in extended hepatectomy group experienced longer duration of operation and more bleeding during operation.Complication incidence rate for group of extended hepatectomy was lower than that for limited hepatectomy group.For group of extended hepatectomy,there was no die during perioperative period while 2people died during perioperative period in limited hepatectomy group.Besides,for extended hepatectomy group,21 cases were conducted with RO resection with resection rate of(21/22)95.5% while 20 cases were conducted with RO resection with resection rate of(20/39)51.3% for limited hepatectomy group(P<0.05).Actuarial 1-,3-and 5-year survival rates were 77.27,36.36 and 13.64 percent respectively in the extended hepatectomy group,and 69.23,20.51 and 1.64 percent for limited hepatectomy group(P<0.05).Conclusions:Extended hepatectomy for patients with HCCA of Bismuth-Corlette type Ⅲ and Ⅳhad better results.It could effectively increase resection rates of RO and survival rate.Meanwhile,prognosis of patients can be improved. |
