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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.
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<p><b>OBJECTIVE</b>To investigate the association of artemin and GFRalpha3 expressions with perineural invasion and metastasis of pancreatic carcinoma.</p><p><b>METHODS</b>Semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry were used to detect the expression of artemin and GFRalpha3 in pancreatic carcinoma tissues, adjacent tissues and normal pancreas tissues, and the relevance of artemin and GFRalpha3 expressions to the perineural invasion and metastasis of pancreatic carcinoma were analyzed.</p><p><b>RESULTS</b>The positivity rates of artemin and GFRalpha3 expressions were 72.09% and 67.44% in pancreatic carcinoma, respectively, significantly higher than those in the adjacent tissue (18.19% and 22.73%). The positivity rates of artemin and GFRalpha3 expressions were significantly higher in patients with perineural invasion than in those without perineural invasion (chi(2)=11.11 and 11.78, respectively, P<0.01). Significantly higher expression of artemin mRNA was noted in pancreatic carcinoma (0.741-/+0.014) than in the normal pancreas tissue (0.101-/+0.031, P<0.05), and patients with perineural invasion showed significantly higher positivity rates of artemin mRNA expression (0.843-/+0.012) than those without perineural invasion (0.512-/+0.017, P<0.05).</p><p><b>CONCLUSION</b>Artemin and GFRalpha3 expressions may play an important role in perineural invasion of pancreatic carcinoma and can be used a useful indicators for evaluating the biological behavior of pancreatic carcinomas.</p>