Postoperative Follow-Up Study Of Hilar Cholangiocarcinoma

Objective To investigate the diagnosis and surgical efficacy of hilar cholangiocarcinoma,and further deepen the understanding of the disease.Methods Select 36 cases which from January 2008- December 2015 Zhangzhou, Fujian Medical University Hospital and confirmed by imaging and pathologic specimens, retrospective study the clinical manifestations, surgical, pathological diagnosis, postoperative complications, according to the treatment,all cases divided into radical group(A), palliative resection group(group B), drainage group(group C), and each treatment group were followed up for telephone follow-up manner, according to the results of follow-up, patients with long-term efficacy analysis comparing different surgical methods.Results Patients with major clinical manifestations of jaundice, 92%(33/36); tumor markers: all patients were elevated CA199(100%);auxiliary examination: this group of 27 cases MRCP examination, the diagnostic value of targeting 100%, combined with B ultrasound and abdominal CT inspection, diagnostic accuracy rate was 91.6%(11/12); The group of resection rate 52.8%(19/36), wherein A group accounted for 30.6%(11/36) in group B 22.2%(8/36); the whole group complication rate 44.5%(16/36), A, B, C three group complication rate was 45.5%(5/11), 75%(6/8), 29.4%(5/17), the incidence of complications between the groups was not statistically significant(PAB=0.395,PAC=0.255,PBC=0.079),two cases of perioperative death one died of bile leakage, recurrent infections, sepsis, liver failure, another patient died of abdominal bleeding, circulatory, respiratory failure; 36 cases of patients in addition to the two deaths, followed up data of 32 cases, the total follow-up rate was 88.9%(32/36), A group after 1, 3, 5-year survival rates were 54.5%, 27.3%, 9.1%; group B after 1, 3-year survival rate was 50.0%, 12.5%, no 5-year survivors; C group 1 year survival rate was 17.6%, without a 3-year survivors, A, B, C group median survival time was(31.4 ± 6.6) M,(13.9 ± 3.8m) M,(9.4 ± 1.8) M, survival difference between the three groups was statistically significant(X2 = 10.35, P = 0.006 <0.05), A group survival rate was significantly higher than group B, group C patients, the difference was statistically significant (X2 = 5.17, P = 0.02 <0.05, X2 = 8.45, P = 0.004 <0.05); the difference between survival groups B and C patients was not statistically significant(X2 = 1.38, P = 0.239> 0.05).Conclusion In the way of the treatment of hilar cholangiocarcinoma, radical resection is still the main method to improve long-term survival, as for the patient which preoperative clinical symptoms and signs are not typical, positive laboratory tests, MRCP or B-joint and abdominal CT can improve the early diagnosis of the disease, as for the patient who can not be radical resection, we can choose palliative drainage treatment to improve the patient’s quality of life.