The Surgical Diagnosis And Treatment Of Hilar Cholangiocarcinoma

Objective:To investigate the diagnosis and surgical treatment for hilar cholangiocarcinoma.Methods:To analyze the clinical data of 4 patients (Three cases of hilar cholangiocarcinoma, and a misdiagnosis case) retrospectively from Jan.2008 tO Dec.2010 in our hospital. Relevant literature was reviewed. Analysis of the surgical outcome and prognostic factors for hilar cholangiocarcfinonm Results:of the 4 patients, the misdiagnosis recovered,2 cases underwent radiclal resection,1 underwent palliative resection and internal drainage. Two patients had survived for more than 2 years in the radical resection, only one death.Conclusion:The primary symptoms were upper abdominal malaise, inertia, appetite decline, weight loss and progressive jaundice. B mode ultrasonography, CT, MRI and MRCP were the good methods for atraumatic diagnosis. Combined use of imaging examinations can improve the rate of diagnosis in hilar.cholangiocarcinoma. Once the patients are diagnosed suffer from hepatic hilar cholangiocarcinoma, they should undergo exploratory laparotomy. Currently, extrahepatic bile duct resection, regional lymphadenectomy hepatic lobectomy, extended hepatic lobectomy recommended the treatment of choice for most patients with hilar cholangiocareinoma. Curative resection and hepatectomy are the main related factors influencing the therapy efficacy. Palliative resection and nonresectional drainage could prolong the life or improve the quality of life among the patients with hilar cholangiocarcinoma. the palliative cholangio-jejunostomy and internaldrainage is first choice a case which is not suitable for resection, Lymph nodal and perineuim involvement resection plays an important role for long-term survival. Combined PVI with hemihepatetomy and caudate bectomy for hilar cholangiocarcinorna did not increase perioperative mortality and morbidity, negative histologie margins, concomitant partial hepatetomy, and degree of histological, related to tumor staging, surgical treatment and other factors affect the prognosis of patients, radical resection is the most important prognostic factor of hilar cholangiocareinoma...