Résumé
Objective To investigate the clinical effect of laparoscopic and open radical resection of hilar cholangiocarcinoma (Bismuth-I). Methods From January 2011 to January 2017, 34 patients (10 patients in the laparoscopic group and 24 patients in the open group) underwent radical resection of hilar cholangiocarcinoma. Their clinical data were analyzed retrospectively. Results All these patients underwent radical resection of hilar cholangiocarcinoma of type Bismuth-I successfully. The volume of blood loss was (179.50 ± 98.05) ml and duration of hospital stay was (11.80 ± 2.49) d of laparoscopic group which was lower than (261.25 ± 97.33) ml, (16.25 ± 3.35) d of open group (P < 0.05). The levels of Tbil of laparoscopic group at days after operation 1, 3, 5 d were (102.20 ± 45.49) mmol/L, (83.57 ± 30.66) mmol/L, (45.09 ± 18.41) mmol/L. The levels of Tbil of open group at days after operation 1, 3, 5 d were (148.17 ± 62.78) mmol/L, (121.60 ± 43.35) mmol/L, (80.59 ± 43.89) mmol/L. The difference was statistically significant (P < 0.05). And the laparoscopic group postoperative number of lymph nodes dissected (9.79 ± 3.05), postoperative complications (1 cases), positive margin (0 cases); and open group(9.30 ± 3.06), 3 cases, had no statistically significant differences were compared (P >0.05). Two groups of patients were followed up for 6~18 months. During the follow-up period, there was no recurrence or metastasis in the two groups. Conclusion Laparoscopic Bismuth-I radical resection of hilar bile duct carcinoma in lymph node dissection, postoperative complications, positive margin rate, prognosis and open type Bismuth-I hilar cholangiocarcinoma radical operation of similar effects, and more minimally invasive advantages. Therefore, laparoscopic radical resection for hilar cholangiocarcinoma of type Bismuth-I is safe and feasible.