A Retrospective Study Of Laparoscopic And Open Radical Resection For Hilar Cholangiocarcinoma

Objective:To analyze the perioperative data of laparoscopic radical resection for hilar cholangiocarcinoma(LRRHC)and open radical resection for hilar cholangiocarcinoma(ORRHC).Compare the general data,intraoperative conditions and postoperative recovery of laparoscopic and open radical resection for hilar cholangiocarcinoma to discuss the feasibility and safety of laparoscopic radical hilar cholangiocarcinoma.Methods:28 cases diagnosed as hilar cholangiocarcinoma and selected from the Qilu Hospital of the Shandong University from October 2015 to February 2020.Among them,16 cases of laparoscopic resection were taken as the experimental group,and 12 cases of radical hepatectomy for hilar cholangiocarcinoma were used as the control group according to the matching conditions of patients' sex,age,tumor location,size and other conditions.Compare the preoperative general data(age,sex,weight,tumor size,etc.),intraoperative data(operation time,intraoperative blood loss,knife length,presence or absence of blood transfusion),postoperative data(drainage tube removal time,operation Posthospitalization time,postoperative liver function,etc.)and postoperative complications(biliary leakage,abdominal bleeding,liver failure,knife edge infection,postoperative gastroparesis,etc.).Results:The general data of the two groups of patients(age,gender,body weight,tumor size,etc.)were not statistically different(P>0.05).The LRRHC group completed the operation under laparoscopic surgery,and none of them converted to open surgery,and the bile duct resection margin was negative.The LRRHC group There was no perioperative death:in all patients included in this study in ORRHC group.The operation time of LRRHC group was longer than that of ORRHC group,the difference was statistically significant(267.7±65.4min vs 141.25±25.9,P<0.05)Blade length(7.9±3.5cm vs 25.6±2.9,P<0.05),postoperative hospital stay(10±2.8d vs 15.3±3.8d,P<0.05),postoperative drainage tube carrying time,etc.(11.8±3.9d vs 15.9±5.6 d,P<0.05)was better than ORRHC group,the difference was statistically significant,the postoperative complications of the two groups of patients were bile leakage,abdominal bleeding,abdominal infection,liver failure,knife edge infection,postoperative gastroparesis There were no statistically significant differences(P>0.05).There were no statistically significant differences in TBIL,AST,ALT,and ALB between the two groups of patients before,on day 1,postoperative day 3,and postoperative day 5(P>0.05).Conclusions:After a long period of laparoscopic surgery training,laparoscopic radical hilar cholangiocarcinoma surgery is safe and feasible.With the benefit of laparoscopic magnification,surgery can be more intuitive,more accurate,easier and safer Later,the patient recovered faster,suffered less pain,had a more beautiful knife edge,and reduced the incidence of complications.