Extrahepatic bile duct resection in patients with hepatocellular carcinoma with bile duct tumor thrombi
10.3760/cma.j.issn.1007-8118.2018.06.009
- VernacularTitle:肝外胆管切除对肝细胞癌合并胆管癌栓患者的意义
- Author:
Aixiang LIU
1
;
Haiqing WANG
;
Wentao BO
;
Xielin FENG
;
Lang TIAN
;
Hui ZHANG
;
Mingyi ZHANG
;
Yong HU
Author Information
1. 电子科技大学临床医学院附属四川省肿瘤医院肝胆外科
- Keywords:
Carcinoma,hepatocellular;
Bile duct tumor thrombi;
Hepatectomy;
Thrombectomy;
Extrahepatic bile duct resection
- From:
Chinese Journal of Hepatobiliary Surgery
2018;24(6):395-399
- CountryChina
- Language:Chinese
-
Abstract:
Objective To review the role of extrahepatic bile duct resection in patients with hepatocellular carcinoma with bile duct tumor thrombi.Methods The Pubmed,Wan Fang and China Science and Technology Journal Database were reviewed systematically.Any case reports or studies involving treatment of hepatocellular carcinoma with bile duct tumor thrombi were included in this literature search.Two authors independently assessed the studies for inclusion and extracted the data.Univariate analysis was used to compare the baseline characteristics and the Kaplan-Meier method was used for analyzing survival and diseasefree survival outcomes.Results Using predetermined inclusion criteria,16 studies which included 170 patients entered into this study.All these patients underwent surgical resection of hepatocellular carcinoma and bile duct tumor thrombi.Based on the Satoh classification,45 patients were type Ⅰ,107 patients type Ⅱ and 18 patients type Ⅲ.Twenty-four patients underwent liver resection combined with extrahepatic bile duct resection.The remaining 146 patients underwent liver resection combined with thrombectomy.The 1-,3-,and 5-year survival rates of all the patients were 73.4％,41.5％ and 21.8％,and the corresponding recurrences free survival rates were 62.5％,29.2％ and 13.1％,respectively.On Kaplan-Meier analysis,there were no significant differences in the survival outcomes between the 2 groups of patients,(P ＞ 0.05).The 1-,3-,and 5-year survival rates of the extrahepatic bile duct resection group were 66.7％,41.7％ and 12.5％,and those of the thrombectomy group were 74.6％,41.3％ and 23.8％,respectively.On subgroup analysis (Satoh type Ⅱ and Ⅲ),no significant differences were observed between the two groups (P ＞0.05).The 1-,3-,and 5-year survival rates of the extrahepatic bile duct resection group were 65.2％,38.0％ and 13.0％,and those of the thrombectomy group were 72.8％,39.5％ and 20.9％,respectively.Conclusion Extrahepatic bile duct resection did not improve the overall survival of patients with hepatocellular carcinoma with bile duct tumor thrombi.
