ABSTRACT
<p><b>OBJECTIVE</b>To summarize the clinical experience and the role of hepatectomy with portal vein resection and reconstruction hilar cholangiocarcinoma.</p><p><b>METHODS</b>From 1998 to 2003, the clinical records of 118 cases with hilar cholangiocarcinoma were reviewed.</p><p><b>RESULTS</b>Of the 118 patients, 66 were performed palliative treatment; and 52 patients underwent radical resection, of which 47 patients, including 11 cases combined with portal vein resection and reconstruction, underwent hepatectomy. The rate of postoperation complication was 22.9% and 27.3% in hepatectomy with or without portal vein resection and reconstruction respectively. The 1, 3-year survival rate were 85.7%, 31.4% and 81.8%, 27.8% in hepatectomy with or without portal vein resection and reconstruction respectively (P > 0.05). Only 5 patients were alive more than 3 years (7.58%), and no patient with palliative treatment lived over 5 years.</p><p><b>CONCLUSIONS</b>Portal vain invasion is not the contraindication of resection for hilar cholangiocarcinoma. Hepatectomy with portal vein resection and reconstruction may raise the radical resection rate of hilar cholangiocarcinoma and improve the results of prognosis.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bile Duct Neoplasms , Pathology , General Surgery , Bile Ducts, Intrahepatic , Cholangiocarcinoma , Pathology , General Surgery , Follow-Up Studies , Hepatectomy , Methods , Neoplasm Invasiveness , Portal Vein , Pathology , General Surgery , Prognosis , Plastic Surgery Procedures , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the secondary operation methods and the effects on the prognosis of unexpected gallbladder cancer (UGC).</p><p><b>METHODS</b>A retrospective analysis on the clinical data was made for 41 patients who underwent extended radical excision from June 1995 to December 2002. Among the patients, 12 were male, 29 were female. The average age was 51 years old. The 41 patients had undergone gallbladder excision because of cholecystitis complicated lithiasis of gallbladder (32 cases), polypi of gallbladder or adenoma (9 cases). Postoperative pathology showed that 32 cases were adenocarcinoma of gallbladder, 6 cases were squamous carcinoma, 3 cases were squamous adenocarcinoma. Six cases were on the stage of Nevin I, 16 on Nevin II, 17 on Nevin III, 2 on Nevin IV. The second operation was performed after 6-30 d of the first operation. The second operation chose the improved method of Glenn excision of carcinoma of gallbladder.</p><p><b>RESULTS</b>On the second operation, 14 cases were with lymphatic metastasis, 14 with gallbladder metastasis, 6 with bile duct metastasis, 2 with pancreas metastasis. Fourteen cases were on the stage of Nevin IV, 9 on Nevin V, none on Nevin I, II and III. After the second operation, 1 year survival rate was 100% (41 cases); The three-year survival rate was 53.8% (22 cases); The five-year survival rate was 17.5% (7 cases).</p><p><b>CONCLUSION</b>Extended radical excision is one of the most important methods for the treatment of UGC.</p>