Comparation Of Varied Palliative Treatment Of Hilar Cholangiocarcinoma

Objective:There is still no standard guideline for the surgical treatment of hilar cholangiocarcinoma(HCCA) patients who cannot receive curative resection. This retrospective study is to compare the outcomes of palliative resection、internal drainage with biliary stent、external biliary drainage with surgery and percutaneous transhepatic cholangial drainage,and to investigate the best treatment of HCCA patients who cannot receive curative resection.Methods:A total of 52 HCCA patients who received different kinds of treatment retrospectively were followed up and evaluated. They were divided into 5 groups according to their treatment regimen: Group of biliary stent; Group of external biliary drainage with surgery; Group of percutaneous transhepatic cholangial drainage(PTCD); Group of R2 palliative resection; Group of R1 palliative resection. Overall, median survival time and 1-year survival rate were analyzed using the Kaplan-Meier survival curve and logrank test.Result:There were no statistical significance in the survival time and 1-year survival rate in group of biliary stent, group of external biliary drainage with surgery and group of PTCD; the median survival time and 1-year survival rate were 10 months, 11 months and 11 months; 37.5%, 28.6% and 44.4%, respectively. There were statistical significance in group of R2 resection and R1 resection; the median survival time and 1-year survival rate were 16 months and 21 months; 70.0% and 77.8%. There were statistical significance in group of R1 or R2 resection and group of biliary stent or group of external biliary drainage with surgery or group of PTCD.Conclusion:The palliative resection(R1 resection and R2 resection) was a better treatment than the treatment of biliary stent and external biliary drainage with surgery and PTCD. R1 resection was better than R2 resection. There were no significance among biliary stent, external biliary drainage and PTCD. R1 resection was the best palliative surgical treatment.