The Efficacy Of Biliary Cancer Resection With Pancreaticoduodenal Preservation For Radical Distal Cholangiocarcinoma

Objective: The article mainly observes the efficacy of biliary cancer resection with pancreaticoduodenal preservation for radical distal cholangiocarcinoma,and to compare the clinical efficacy of conventional pancreaticoduodenectomy.Methods: By retrospective analysis of the 28 patients with distal cholangiocarcinoma of general surgery department,the Second Hospital of Lanzhou University from March,2012 to December,2014.According to the patient's will and case,selecting the medical records meeting the requirements for biliary cancer resection with pancreaticoduodenal preservation(observation group,n = 13),analyze the clinical efficacy and to compare the clinical efficacy of conventional pancreaticoduodenectomy(control group,n = 15).All the data(including the cumulative recurrence rate,overall survival rate,overall survival time,intraoperative blood loss,operation time,incidence of postoperative complications,postoperative hospital stay,hospitalization cost,)were handled by SPSS22.0 statistic software.P<0.05 was considered statistically significant.Enumeration data were analyzed by the Fisher test.Gather data were showed by mean ± standard deviation(x ± s),and analyzed by the t test.Results:1.For the biliary cancer resection with pancreaticoduodenal preservation group(observation group),the 1-year,3-year and 5-year overall survival rates were 76.9%,46.2%,15.4%,respectively;For the traditional pancreaticoduodenectomy group(control group),the 1-year,3-year and 5-year survival rates were 73.3%,40%,and 26.7%,respectively.There was no significant difference between the two groups in 1-year overall survival rate(P=1.000),3-year survival overall rate(P=1.000),and 5-year overall survival rate(P=0.655).2.For the biliary cancer resection with pancreaticoduodenal preservation(observation group),the 1-year,3-year and 5-year cumulative recurrence rates were 38.5%,53.8%,and 69.2%,respectively;For the traditional pancreaticoduodenectomy group(control group),the 1-year,3-year and 5-year cumulative recurrence rates were 33.3%,53.3%,66.7% respectively.There was no significant difference between the two groups in 1-year cumulative recurrence rate(P=1.000),2-year cumulative recurrence rate(P=1.000),and 3-years cumulative recurrence rate(P=1.000).3.There were 2(15.4%)of complications in the biliary cancer resection with pancreaticoduodenal preservation group(observation group),including 1 case of abdominal hemorrhage and 1 cases of pleural and abdominal effusion.There were 9(60%)case of complications in the traditional pancreaticoduodenectomy group(control group),including 2 cases of abdominal hemorrhage,1 case of incision infection,5 cases of pleural and peritoneal effusion and 1 case of biliary leakage.There was significant difference in the incidence of postoperative complications between the two groups(P<0.05).4.The operation time of the two groups were(3.38±1.121)h and(7.80±1.897)h,respectively.There was significant difference in the operation time between the two groups(P<0.05).The Intraoperative bleeding of two groups were(315.38±128.103)mL and(713.33±264.215)mL,respectively.There was significant difference in Intraoperative bleeding between the two groups(P<0.05).The postoperative hospital stays of the two groups were(14.69±6.600)days and(19.00±7.521)days,respectively.there was no significant difference in postoperative hospital stay between the two groups(P> 0.05).The hospitalization costs of the two groups were(79721.86±21938.181)yuan and(99674.57±28174.809)yuan,respectively.There was significant difference in hospitalization costs between the two groups(P<0.05).Conclusion:1.There was no significant difference in the 1-year,3-year 5-year overall survival rate and the 1-year,2-year,3-year cumulative recurrence rate between the biliary cancer resection with pancreaticoduodenal preservation group and the traditional pancreaticoduodenectomy group;2.The biliary cancer resection with pancreaticoduodenal preservation can reduce postoperative complications;3.The biliary cancer resection with pancreaticoduodenal preservation can reduce hospitalization costs.In summary,the results of this study suggest that selective the biliary cancer resection with pancreaticoduodenal preservation for some eligible cases may result in clinical gain.