| Part Ⅰ Clinical analysis of the correlation between hilar cholangiocarcinoma and hepatitis B infectionObjective: To analyze the correlation between hilar cholangiocarcinoma and,hepatitis B recent-infection as well as past-hepatitis B infectionMethods: Overall,168 patients with hilar cholangiocarcinoma who underwent surgical resection at Tongji Hospital from April 2012 to September 2019 were retrospectively studied.The correlation between HBV infection serologic markers and hilar cholangiocarcinoma was analyzed by comparing the tumor characteristics of patients with positive and negative hepatitis B markers.Results: Among 168 patients,125 patients(74.4%)were with positive HBV markers reflecting HBV recent-infection or past-infection including HBs Ag,HBe Ag,HBe Ab,HBc Ab);of them,18 cases were HBs Ag(+),2 cases were HBe Ag(+),49 cases were HBe Ab(+),124 cases were HBc Ab(+),and 43 cases(25.6%)with negative HBV markers including all negative or only HBs Ab positive).The mean age of patients with positive HBV markers was 55.95 years that was significantly younger than that of patients with negative HBV markers(59.07 years)(P <0.05).Conclusion: The HBs Ag positive rate in the patients with hilar cholangiocarcinoma was comparable to the general population,but the hepatitis B past-infection rate was significantly higher than that of the general population.The patients with the background of hepatitis B infection were younger.Part Ⅱ: The impact of hepatitis B recent-infection and past-infection on the operative safety of major hepatectomy for hilar cholangiocarcinomaObjective: To study the effect of hepatitis B recent-infection and past-infection on the operative safety of major hepatectomy for hilar cholangiocarcinoma.Methods: The clinicopathological data of 112 patients who underwent major hepatectomy for hilar cholangiocarcinoma were retrospectively collected from April 2012 to September 2019.The patients’ preoperative data,surgical data and postoperative data were analyzed by spss22.0 data package,the safety of major hepatectomy for hilar cholangiocarcinoma in hepatitis B infection background was evaluated.Results: The incidence of postoperative complications and 30-day mortality in the group were 75.0% and 6.3%,respectively.There were 82 patients in HBc Ab(+)group and 30 patients in HBc Ab(-)group.The difference of intraoperative blood loss(<800/≥800ml)between the two groups was statistically significant(P<0.05).The amount of intraoperative blood loss in HBc Ab(+)group was significantly higher than that in HBc Ab(-).The incidence of postoperative complications(78.0%)was significantly higher in the HBc Ab(+)group than in the HBc Ab(-)group(53.3%)(P<0.05);the incidence of postoperative massive ascites(36.6%)was significantly higher in the HBc Ab(+)group than in the HBc Ab(-)group(13.3%)(P<0.05),while the incidence of postoperative massive ascites(61.5%)in the HBc Ab(+)group was significantly higher than that in the HBs Ag(-)group(31.9%)(P<0.05);the incidence of postoperative liver failure in the HBc Ab(+)group (18.3%)was significantly higher than that in the HBc Ab(-)group(3.3%)(P<0.05).The 30 days-mortality of HBc Ab(+)group was significantly higher than that of HBc Ab(-)(P< 0.05).Conclusion: The risk of major hepatectomy for hilar cholangiocarcinoma was significantly increased in the patients with HBV infection(HBc Ab positive),furthermore,the risk of the patients with hepatitis B recent-infection(HBs Ag positive)was even higher than that in the patients with hepatitis B past-infection. |
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