Minor liver resection for hilar cholangiocarcinoma of Bismuth-Corlette type Ⅲ and Ⅳ
10.3760/cma.j.issn.0529-5815.2019.07.009
- VernacularTitle: 小范围肝切除治疗Bismuth-Corlette Ⅲ、Ⅳ型肝门部胆管癌的临床经验
- Author:
Enshan LI
1
;
Yanlei SUN
1
;
Xuejian LIU
2
;
Qingpin TAI
1
;
Rongfei ZHAO
1
;
Shifang LYU
1
;
Xiaoping CHEN
3
Author Information
1. Department of Hepatobiliary Surgery, Linyi Tumor Hospital, Linyi 276001, Shandong Province, China
2. Tumor Center, People′s Hospital of Linyi Economic Development Zone, Linyi 276023, Shandong Province, China
3. Hepatobiliary Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Publication Type:Journal Article
- Keywords:
Biliary tract neoplasms;
Hepatectomy;
Therapy
- From:
Chinese Journal of Surgery
2019;57(7):523-526
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effect and safety of minor liver resection for hilar cholangiocarcinoma (HC) of Bismuth-Corlette type Ⅲ and Ⅳ.
Methods:From May 2007 to May 2017, the clinical data of 108 patients with Bismuth-Corlette type Ⅲ and Ⅳ HC underwent hepatectomy were collected and analyzed retrospectively.There were 56 males and 52 females, aged (57.2±5.3) years (ranged 48-76 years) .Among the 108 cases, there were 51 cases of type Ⅲa, 40 cases of type Ⅲb and 17 cases of type Ⅳ. Small-scale hepatectomy (≤3 hepatectomy) was performed in 70 cases, including 8 cases of 4b segment resection, 28 cases of 4b segment+5 segment resection, and 34 cases of partial 4 segment+partial 7 segment+partial 1 segment resection. Large-scale hepatectomy was performed in 38 cases (>3 segments) , of which 30 cases were treated with 2 segments+3 segments+4 segments+1 segment, and 8 cases were treated with 5 segments+7 segments+8 segments+1 segment. t′ test was used to analyze the data which did not conform to the normal distribution, and χ2 test was used to calculate the incidence of postoperative complications and the 1, 3, and 5-year cumulative overall survival rate.
Results:(1) The operation time of minor liver resection group ((180±25)minutes) was shorter than that of major liver resection group ((210±35)minutes) (t′=4.676, P<0.05) , the amount of blooding operation time of minor liver resection group ((310±80)ml) was less than that of major liver resection group ((500±110)ml)in the operation (t′=9.385, P<0.05) , and the difference was statistically significant. (2) The incidence of complications was lower in minor liver resection group and major liver resection group, and the difference was statistically significant (χ2=5.230, P<0.05) . (3) The actual 1-, 3- and 5-year survival rates were 87.1%, 58.4%, 30.0% and 84.2%, 57.9%,31.6%, respectively. There were no significant differences in survival rates in two groups in 1-, 3- and 5-year survival rates (χ2=0.177, P=0.674; χ2=0.005, P=0.946; χ2=0.029, P=0.865) .
Conclusions:Compared to patients with major liver resection, Minor liver resection for selected patients with HC of Bismuth-Corlette Ⅲ and Ⅳaccording to our criteria achieved better long-term outcomes. Chen′s biliojejunostomy is a simple, effective and safe method, which can be widely used when there are multiple biliary intestinal anastomosese.
