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Objective:To investigate surgical treatment and efficacy of hilar cholangiocarcinomaMethods: From January 2000 to September 2007,129 patients with hilar cholangiocarcinoma in our deparment, were analyzed retrospectively. Results: Of all 129 cases, 113 cases had been surgically explored, 16 patients had not been operated. Among the 113 cases ,60 cases had been radically resected, and the resection rate is 53.9%, R0 resection had been made for 48cases, and R1 or R2 palliative resection had been made for 12cases, among the radical resection, the hepatic lobectomy of 30 cases including partial caudate resection, in which positive margin of the caudate lobe duct was in 9 cases show by pathological examination. 53 cases have been explored, which could not resecte the cancer and only bypass drainage, of the 53cases,46 cases of biliary–enteric drainage have been done, and 7cases of external drainage have been done. The median survival time (47.86 months)of radical resection was longer than that of palliative surgery (14.83 months), the median survival time of 16cases ,the patients who did not have surgery is(10 months ).the 1-,3-and5-year survival rates of radical resection were 95.83%,62.50%and 33.33% respectively, which was longer than that of the palliation therapy of 53 patients with unresectable cholangiocarcinoma,the 1-,3-and5-year survival rates were 56.92%,12.31%and 0%,Whereas the 1-,3-,and5-year survival rates of 16 cases were 31.25%,0%,0%.Conclusion:1 Radical resection is the main therapy for hilar cholangiocarcinoma.2 If tumor invasion to the bifurcation of the common hepatic duct ,the caudate lobe should be resected.3 The palliation therapy of patients with unresectable cholangiocarcinoma should be centered on quality of life concerns.
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