Diagnosis and treatment for postoperative complications after radical resection of hilar cholangiocarcinoma
10.3877/cma.j.issn.2095-3232.2015.04.004
- VernacularTitle:肝门部胆管癌根治性切除术后并发症的诊断与治疗
- Author:
Xiao HU
1
;
Weiyu HU
;
Chuandong SUN
;
Lin SUN
;
Shun ZHANG
Author Information
1. 266033青岛大学附属医院肝胆胰外科器官移植中心
- Keywords:
Bile duct neoplasms;
Postoperative complications;
Diagnosis;
Therapeutics
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2015;(4):206-209
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the diagnosis and treatment for postoperative complications after radical resection of hilar cholangiocarcinoma.MethodsClinical data of 60 patients with hilar cholangiocarcinoma undergoing radical resection in the Afifliated Hospital of Qingdao University between July 2011 and February 2014 were retrospectively studied. Among the 60 patients, 46 were males and 14 were females with the age ranging from 41 to 80 years old and the median of 65 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. All patients underwent R0 resection and the main surgery was resection of cholangiocarcinoma and cholecystectomy + Roux-en-Y anastomosis. Seven cases underwent combined left hemihepatectomy, 1 combined right hemihepatectomy, 2 combined partial mesohepatectomy and 4 combined caudate lobectomy. Theincidence of postoperative complications and the diagnosis and treatments were analyzed.ResultsThe incidence of postoperative complications after radical resection for hilar cholangiocarcinoma was 30% (18/60), in which, 2 cases developed active intra-abdominal hemorrhage, 6 bile leakage, 4 ascites complicated with infection, 4 pulmonary infection and 2 incision infection. The 2 cases who developed active intra-abdominal hemorrhage received treatments such as accelerating the infusion speed, blood transfusion and use of hemostatic. Surgical exploration was then performed to stop bleeding when conservative treatments failed. The 6 cases who developed bile leakage and 4 cases who developed ascites complicated with infection underwent percutaneous catheter drainage under the guide of ultrasound or CT or by interventional operation. These patients were cured after effective drainage, anti-infection treatment and nutritional support. The 4 patients who developed pulmonary infection were cured after symptomatic treatments such as body turning over, back slapping, anti-infection treatment and expectorant medication. The 2 patients who developed incision infection were cured after receiving treatments such as antibiotics, changing dressing timely and supplement of albumin and fresh plasma.ConclusionsThe incidence of postoperative complications after radical resection for hilar cholangiocarcinoma is high. Active intra-abdominal hemorrhage is extremely dangerous, which shall be diagnosed early and treated positively, and surgical hemostasis shall be performed when necessary. Bile leakage is the common complication. Strengthening the drainage and anti-infection is very important.
