Effect evaluation of vascular resection for patients with hilar cholangiocarcinoma: original data and meta-analysis.

摘要

To evaluate the effect of vascular resection (VR) in surgical management of hilar cholangiocarcinoma (HCCA), this report did a clinical analysis and conducted a systematic review, combined other studies, based on meta-analysis.Two hundred and thirty eight HCCA patients underwent hepatectomy in the Eastern Hepatobiliary Surgery Hospital. Binary logistic regression analysis was performed to investigate the potentially complications associated factors. Kaplan-Meier test was employed to compare the long-term survival of patients in four groups (RO + PVR-free, RO + PVR, R1 and R2). Meta-analysis was performed with RevMan 4.3.2 software.The results suggested that hepatectomy and HAR were important negative factors from complications (P < 0.01). Compared with patients in other groups, survival of patients in RO + PVR group was worse than RO + PVR-free group, better than R2 group and similar to R1 group with P = 0.001, 0.047 and 0.606 respectively. The results of meta-analysis suggested patients who underwent VR had higher complications rate and mortality rate than patients who did not. Moreover, patients with vascular resection had lower long-term survival rate.VR used to be considered effective to the patients with vascular invasion. However our study suggest that the surgical decision of undergoing VR should be made cautiously, since VR could diminish the survival time in some cases.