Abstract:
Objective To investigate the clinical effect of laparoscopy and laparotomy in radical resection of Bismuth Ⅰ hilar cholangiocarcinoma.
Methods From January 2013 to December 2015, 27 patients with Bismuth Ⅰ hilar cholangiocarcinoma underwent laparoscopic or open surgery in our hospital, whose clinical data were analyzed retrospectively, including 14 cases in laparotomy group and 13 cases in laparoscopic group. Data analysis were performed by using SPSS20.0 software. Measurement data such as perioperative indexes were expressed as mean±standard deviation and were examined by independent t test. The incidence of complications were examined by chi square test. Survival was analyzed by kaplan-meier method. A P value of <0.05 was considered as statistically significant.
Results There were no significant difference in terms of harvested lymph nodes, postoperative exhaust time and positive cases of surgical margin between the two groups (P>0.05). The operation time in laparoscopic group was longer than that in open group, while intraoperative bleeding, pain and hospitalization time were significantly better than those in laparotomy group, with statistically difference (P<0.05). There was no significant difference in terms of liver function indexes between the two groups before operation (P>0.05). On the 3rd day after operation, TBIL, Alb in both groups was significantly lower than those before operation respectively, TBIL in laparoscopy group was lower than that in laparotomy group, Alb in laparoscopy group was higher than that in laparotomy group, ALT, AST in both groups were significantly higher than those before operation, with lower level in laparoscopy group than those laparotomy group respectively (P<0.05). There was no significant difference in terms of incidence of postoperative complications and 1, 3-year cumulative survival rate between the two groups (P>0.05).
Conclusion Compared with open surgery, laparoscopic radical resection of Bismuth Ⅰ hilar cholangiocarcinoma have advantages of smaller incision, less bleeding and liver function damage, which is safe and feasible.
Key words:
Bile duct neoplasms,
Laparoscopy,
Laparotomy,
Comparative effectiveness research
Chang Duan, Xushi Zhu, Manzhen Wang, Yanfeng Niu, Wanli Zhang, Shijun Li. Clinical investigation of two surgical methods in radical resection of Bismuth Ⅰhilar cholangiocarcinoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(06): 552-555.