腹腔镜与开腹肝切除术治疗肝内胆管细胞癌患者疗效与安全性研究

目的 比较腹腔镜肝切除术(LLR)与开腹肝切除术(OLR)治疗肝内胆管细胞癌(ICC)患者的疗效与安全性。方法 2015年1月～2018年6月我院诊治的ICC患者74例，其中32例接受LLR手术，另42例接受OLR手术。随访3年。结果 两组年龄、性别、腹部手术史、血清CA19-9和CEA水平、神经侵犯、微血管侵犯、肿瘤低分化、肿瘤直径和淋巴结肿大等差异无统计学意义(P>0.05);LLR组术中失血量、手术切口长度、肝门阻断、术后住院日、输血和胃肠道功能恢复时间分别为325(250,475)ml、5(3.5,6.5)cm、9例(28.1%)、7(5,12)d、2例(6.2%)和2(2,4)d,与OLR组【分别为500(375,750)ml、20.5(17.0,25.0)cm、31例(73.8%)、10(7,15)d、7例(16.7%)和4(3,6)d】比，差异具有统计学意义(P<0.05),而两组1 a生存率(81.2%对76.2%)和3 a生存率(46.8%对33.3%)无显著性差异(P>0.05);术后，两组均未发生严重并发症。结论 在当前情况下，采取OLR或LLR...

Comparison of efficacy and safety of laparoscopic and open liver resection in the treatment of patients with intrahepatic cholangiocarcinoma

Objective The aim of this study was to compare the efficacy and safety of laparoscopic(LLR)and open liver resection(OLR)in the treatment of patients with intrahepatic cholangiocarcinoma(ICC).Methods 74 patients with ICC were enrolled in our hospital between January 2015 and June 2018,and 32 patients received LLR and 42 underwent OLR.All patients in the two groups were followed-up for 3 years.Results There was no significant differences as respect to ages,gender,abdominal operation history,serum carbohydrate antigen 199 and carcinoembryonic antigen levels,nerve invasion,microvascular invasion,tumor low differentiation,tumor diameters and lymph node enlargement between the two groups(P>0.05);the intraoperative blood loss,surgical incision length,hepatic portal occlusion,postoperative hospital stay,percentages of blood transfusion and post-operational gastrointestinal function recovery in patients receiving LLR were 325(250,475)ml,5(3.5,6.5)cm,9 cases(28.1%),7(5,12)d,2 cases(6.2%)and 2(2,4)d,significantly different as compared to[500(375,750)ml,20.5(17.0,25.0)cm,31 cases(73.8%),10(7,15)d,7 cases(16.7%)and 4(3,6)d]in patients receiving OLR(P<0.05),while there were no significant differences in one-year(81.2%vs.76.2%)and three year(46.8%vs.33.3%)survivals between the two groups(P>0.05);no severe untoward effects post-operationally occurred in our series.Conclusion At present,the LLR might be an alternative option for patients with ICC,although the OLR is still underwent in some circumstances,so the surgeon could make choice based on the patients’conditions and the technical requirement.