To compare the safety and long-term efficacy between combining total caudate lobotomy and combining partial caudate lobotomy of hilar cholangiocarcinoma radical resection.

Clinical data of 33 patients with hilar cholangiocarcinoma who underwent radical resection of hilar cholangiocarcinoma combined with caudate lobotomy in the First Affiliated Hospital of Sun Yat-sen University from July 2014 to April 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 23 patients were male and 10 female, aged from 29 to 77 years, with a median age of 60 years. All patients were divided into the total and partial caudate lobotomy groups with a ratio of 1∶1 by propensity score matching (PSM). The short- and long-term clinical efficacy was statistically compared between two groups. The incidence of complications between two groups was compared by Fisher's exact probability test. The operation time was compared by Mann-Whitney U test. Survival analysis was conducted by Kaplan-Meier method and Log-rank test.

After PSM, 13 patients were assigned into the total caudate lobotomy group and 13 cases into the partial caudate lobotomy group. In the total caudate lobotomy group, the median operation time was 390(170) min, significantly longer than 300(63) min in the partial caudate lobotomy group (Z=2.722, P<0.05). In the total caudate lobotomy group, 8 patients developed postoperative complications and 3 cases in the partial caudate lobotomy group, and no statistical significance was noted between two groups (P=0.111). In the total caudate lobotomy group, the 1-, 3-, 5-year overall survival rates were 83.1%, 44.3%, 44.3%, and 67.7%, 25.4%, 25.4% correspondingly in the partial caudate lobotomy group, and no statistical significance was observed between two groups (χ²=0.986, P>0.05). In the total caudate lobotomy group, the 1-, 3-, 5-year recurrence-free survival rates were 63.6%, 27.3%, 27.3%, and 57.7%, 28.8%, 14.4% in the partial caudate lobotomy group, and no statistical significance was found between two groups (χ²=0.004, P>0.05).

Compared with combining partial caudate lobotomy, combining total caudate lobotomy will prolong the operation time in radical resection of hilar cholangiocarcinoma. Nevertheless, the incidence of postoperative complications and long-term survival do not significantly differ between two operations.