To evaluate the value of percutaneous transhepatic cholangial drainage (PTCD) before partial hepatectomy of hepatic hilar cholangiocarcinoma.

Clinical data of 78 patients with hepatic hilar cholangiocarcinoma who underwent partial hepatectomy combined with caudate lobectomy in the First Hospital Affiliated to Army Medical University between January 2008 and January 2013 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to whether preoperative PTCD was performed, patients were divided into the PTCD group (n=57) and non-PTCD group (n=21). In PTCD group, 34 patients were males and 23 were females, aged (57±9) years on average. In non-PTCD group, 12 cases were males and 9 werefemales, aged (54±6) years on average. Total bilirubin (TB) levels and operative time were compared between two groups using t test. The comparison of rates was performed using Chi-square test. Survival analysis was performed using Kaplan-Meier method and Log-rank test.

Upon admission, the TB level in PTCD group was (295±131) μmol/L, which was significantly higher than (137±37) μmol/L in non-PTCD group (t=3.768, P<0.05). TB level decreased to (67±25) μmol/L after PTCD, significantly lower than that in non-PTCD group (t=-5.784, P<0.05). The incidence of PTCD-related complications was 16%(9/57), where cholangitis was 12%(7/57), bleeding 2%(1/57) and implantation metastasis 2%(1/57). The operation time in the PTCD and non-PTCD groups was (490±153) and (488±93) min respectively, where no significant difference was observed (t=0.040, P>0.05). In PTCD group, the blood transfusion rate, R0 resection rate, and incidence of complications were 79%, 79% and 42% respectively, compared with 71%, 86% and 38% in non-PTCD group, where no significant difference was observed (χ²=0.157, 0.122, 0.102; P>0.05). No liver failure or death occurred in both groups. There was no significant difference in the overall survival and disease-free survival between two groups (χ²=1.469, 1.384; P>0.05).

It is safe and effective to apply PTCD before partial hepatectomy of hepatic hilar cholangiocarcinoma, which can significantly reduce the TB level, while does not increase the risk of surgery and does not affect the postoperative long-term survival.