To investigate the clinical effect and prognosis of combined lobectomy with arterial resection and reconstruction for patients of hepatic artery invasion of hilar cholangiocarcinoma(HCCA).

98 cases of HCCA with hepatic artery invasion from October 2016 to October 2019 were retrospectively analyzed. According to different surgical methods, the patients were divided into combined group (HCCA radical surgery + lobectomy + hepatic artery resection, 51 cases) and palliative group (palliative bile duct tumor resection / internal drainage reduction surgery, 47 cases). All the data were analyzed by spss22.0 software. The indexes of the patients in the two groups were expressed by (±s), and independent sample t test was used to compare. The complications were compared by χ² test, Kaplan-Meier was used to plot the survival curve of patients, and P<0.05 was considered statistically significant.

The operation time and hospitalization cost in the combined group were significantly higher than those in the palliative group. The intraoperative blood loss and hospital stay in the combined group were significantly lower than those in the palliative group, and the differences were statistically significant (P<0.05). The complication rate in the combined group was 52.9%, compared with 42.5% in the palliative group, the difference was not statistically significant (P>0.05); no perioperative death occurred in both groups. The follow-up time was up to November 2019. After 1 to 36 months of follow-up, all patients in the combined group had a one-year survival rate, a two-year survival rate, and a three-year survival rate of 84.3%, 66.7%, and 43.1%, which were significantly higher than 17.0%, 10.6%, 4.3% in the palliative group, the differences were statistically significant (P<0.05).

The combined lobectomy with arterial resection and reconstruction can effectively reduce the amount of bleeding and improve the survival rate of patients with HCCA.