ABSTRACT
Objective To investigate the effects of preoperative jaundice relieving on hemihepatectomy of hilar cholangiocarcinoma.Methods The clinical data of 18 patients who received preoperative percutaneous transhepatic cholangiography and drainage (PTCD) or endoscopic nasobiliary drainage (ENBD) before hemihepatectomy at the Tongji Hospital of Huazhong University of Science and Technology from January 2007 to January 2012 were retrospectively analyzed.The condition of the 18 patients (jaundice relieving group) was compared with that of 24 patients (non-jaundice relieving group) who did not receive PTCD or ENBD before hemihepatectomy.The differences in the pre-and postoperative blood loss,blood transfusion,operation time and postoperative incidence of complications between the 2 groups were analyzed.All data were analyzed using the t test or chi-square test.Results After PTCD or ENBD,the levels of total bilirubin (TBil),direct bilirubin (DBil),alanine aminotransferase (ALT) were (27 ± 5) μmol/L,(22 ± 6) μmol/L and (52 ± 42) U/L,which were significantly lower than (287 ± 120)μmol/L,(212 ± 86)μmol/L,and (267 ± 180)U/L before PTCD or ENBD in the jaundice relieving group (t =4.33,6.61,4.19,P ＜0.05).In the jaundice relieving group,left hemihepatectomy was performed on 14 patients,and right hemihepatectomy on 4 patients,and the radical resection rate was 16/18.In the nonjaundice relieving group,left hemihepatectomy was performed on 11 patients,and right hemihepatectomy on 13 patients,and the radical resection rate was 83.3％ (20/24).There was no significant difference in the radical resection rate between the 2 groups (x2 =1.09,P ＞ 0.05).The operation time,volume of intraoperative blood loss,volume of blood transfusion were (5.0 ± 0.8) hours,(562 ± 207) ml and (430 ± 317) ml in the jaundice relieving group,and (6.3 ± 1.5)hours,(815 ± 463)ml and (750 ± 146)ml in the non-jaundice relieving group,with significant differences between the 2 groups (t =4.77,7.80,4.65,P ＜ 0.05).The incidences of postoperative complications,bleeding and postoperative hepatic failure were 3/18,1/18 and 1/18 in the jaundice relieving group,and 75.0％ (18/24),33.3％ (8/24) and 33.3％ (8/24) in the non-jaundice relieving group,with significant differences between the 2 groups (x2=5.14,7.58,7.58,P ＜ 0.05).Conclusion Preoperative jaundice relieving could shorten the operation time and reduce the volume of intraoperative blood loss and the incidence of postoperative complications.
ABSTRACT
ObjectiveTo investigate the relationship between Dicer expression and clinicopathological characteristics and prognosis by detecting the expression of Dicer in hilar cholangiocarcinoma tissues and cells.MethodsThe expression of Dicer in tissues was detected using immunohistochemistry.Western blotting and RT-PCR were used to investigate Dicer expression in QBC939 and HIBEpic cells.The relationship between Dicer expression and clinicopathological characteristics was analyzed.A Kaplan-Maier analysis was performed to analyze the disease-free survival (DFS) and overall survival (OS) after radical surgical resection of hilar cholangiocarcinoma.ResultsWhen compared to control,Dicer was significantly down-regulated in hilar cholangiocarcinoma tissues (P＜0.05) and in QBC939 (P＜0.05).The expression of Dicer was higher in well differentiated adenocarcinoma than poorly and moderately differentiated tumours. Univariate analysis showed low expression of Dicer protein was significantly correlated with short disease-free survival and overall survival of patients with hilar cholangiocarcinoma after radical surgical resection (P＜0.01). Multivariate analysis revealed that the expression of Dicer was the most important factor for predicting prognosis after radical surgical resection of hilar cholangiocarcinoma (P＜0.05).ConclusionsDicer could be used as a prognostic marker for hilar cholangiocarcinoma.