| Objective:Retrospectively analyzed the clinical data of patients with hilar cholangiocarcinoma treated in our hospital,investigated thetreatment and prognosis of the diseaseto have a more scientific understanding of the diseaseand better treatments.Methods:This retrospective study enrolled 32 patients with hilar cholangiocarcinoma at the Department of Hepatobiliary and Pancreatic Surgery,Second Hospital of Jilin Universityand China-Japan Union Hospital of Jilin Universitybetween July 2014 and December 2019.Clinical manifestations,radiological(b-ultrasound scanner,CT,MRI),liver function and tumor markers,treatment,postoperationpathologicaldata and relevant outcomes were collected and analyzed.The patients are divided into 3 groups according to different treatment methods:PTCD group,metal stent implantation through endoscopic or percutaneous transhepatic approach group,exploratory laparotomy group.A retrospective study comparing the short-term clinical efficacy of PTCD,metal stent implantation through endoscopic or percutaneous transhepatic approach and exploratory laparotomy in the treatment of advanced unresectable hilar cholangiocarcinoma,and explore the the difference of three treatment methods in patient survival rate,hospitalization time,hospitalization costs,early complications after treatment,and the recovery of liver function after treatment,the advantages and disadvantages of the three treatment methods were analyzed at the same time,and the preferred treatment method for palliative biliary drainage of obstructive jaundice caused by advanced hilar cholangiocarcinoma was finally evaluated.SPSS 18.0 software was used for statistical analyses.Measurement data were expressed as the mean ± standard deviation(SD)and compared using One-way analysis of variance.Count data were compared using chi-square test,some results were compared using Fisher's exact test.P values of less than 0.05 were considered statistically significant.Result:There were 20 males(62.5%)and 12 females(37.5%),with an average age of 68.48±8.96 years(range 43-86 years).The differences in treatment and prognosis of each group are as follows:(1)The median survival time of 32 cases was 10.33±0.68 months(range 4-18months).The survival rate at 1 year was 25%.The median survival time of 15 cases of PTCD group was 10.37±1.85 months.The survival rate at 1 year was 20%.The median survival time of 10 cases of metal stent implantation through endoscopic or percutaneous transhepatic approach group was 10.21±0.82 months.The survival rate at 1 year was 30%.The median survival time of 7 cases of exploratory laparotomy group was 9.42±1.12 months.The survival rate at 1 year was 28.5%.There was no significant difference in 1-year survival rate among the three groups of patients(P=0.943).(2)The hospitalization time of exploratory laparotomy group was significantly longer than that of PTCD group and metal stent implantation through endoscopic or percutaneous transhepatic approach group(P=0.001?P=0.006).But there was no significant difference in the hospitalization time among PTCD group and metal stent implantation through endoscopic or percutaneous transhepatic approach group(P=0.574).(3)After treatment,TBIL,ALT,and ALP were significantly lower than before,but there was no significant difference in TBIL,ALT,and ALP among three groups(P > 0.05).(4)The exploratory laparotomy group had the most hospitalization costs,followed by metal stent implantation through endoscopic or percutaneous transhepatic approach group and the PTCD group.There was significant difference in hospitalization costs among three groups(P<0.05).(5)The incidence of postoperative complications in PTCD group,metal stent implantation through endoscopic or percutaneous transhepatic approach group,exploratory laparotomy group were 26.6%?10%?42.8%,respectively.There was no significant difference in the incidence of postoperative complications among three groups(P>0.05).Conclusions:1 After three treatment methods,the liver function index decreased significantly after operation,all of which are effective,safe and reliable palliative treatment methods.2 PTCD or metal stent implantation through endoscopic or percutaneous transhepatic approach are preferred choice for drainage. |
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