[Multivariate analysis of the effect of two liver resection methods on the survival outcome of patients with intrahepatic cholangiocarcinoma].

Objective: To investigate the effect of anatomical hepatectomy and non-anatomic hepatectomy in the treatment of elderly patients with intrahepatic cholangiocarcinoma (IHCC) and their impact on survival outcomes. Methods: In this study, a retrospective method was used to select elderly patients with IHCC who were surgically treated in Shangqiu First People's Hospital from April 2014 to April 2018, and were divided into anatomic resection group and non-anatomical resection group according to the surgical methods they received.The factors affecting the survival outcome of IHCC in the two liver resection methods were analyzed and compared, as well as the effects of liver cirrhosis rate, TNM stage, ascites rate, lymph node metastasis rate, and vascular invasion rate on survival. Results: A total of 181 cases were included in this study, including 87 cases in the anatomical resection group, with 54 males and 33 females, aged (71.4±5.2) years old;There were 94 cases in the non-anatomical resection group, including 49 males and 45 females, aged (70.8±4.8) years.The 3-year survival rate of the anatomical resection group was 41.4% (36/87), which was higher than that of the non-anatomical resection group (25.5% (24/94), the difference was statistically significant (P<0.05);The median survival time of the anatomic resection group was longer than that of the non-anatomical resection group, and the difference was statistically significant P<0.05;The patient's TNM stage was stage III [OR (95%CI): 2.168 (1.245-3.776)], lymph node metastasis [1.664 (1.087-2.545)], and vascular invasion [1.883 (1.167-3.038)] was an independent risk factor for death 3 years after surgery (P<0.05), The patient's anatomical liver resection was a protective factor for the 3-year follow-up survival (P<0.05). Conclusion: The postoperative survival of elderly patients with IHCC is affected by many factors, but anatomic liver resection is beneficial to prolong the survival time of patients.目的： 探讨解剖性肝切除术与非解剖性肝切除术治疗老年肝内胆管细胞肝癌（IHCC）患者的效果及对患者生存结局的影响。 方法： 本研究采取回顾性研究方法，选取河南省商丘市第一人民医院2014年4月—2018年4月手术治疗的老年IHCC患者，根据患者接受的手术方法将其分为解剖切除组和非解剖切除组。分析比较两种肝切除方式中对IHCC生存结局影响的因素，以及肝硬化率、TNM分期、腹水率、淋巴结转移率、血管侵犯率等对生存的影响。 结果： 共181例患者纳入本研究，其中解剖切除组87例，男54例，女33例，年龄（71.4±5.2）岁；非解剖切除组94例，男49例，女45例，年龄（70.8±4.8）岁。解剖切除组的3年生存率为41.4%（36/87），高于非解剖切除组的25.5%（24/94），差异有统计学意义（P<0.05）；解剖切除组的中位生存时间长于非解剖切除组，差异有统计学意义（P<0.05）；患者TNM分期为Ⅲ期［OR（95%CI）：2.168（1.245~3.776）］、发生淋巴结转移［1.664（1.087~2.545）］、发生血管侵犯［1.883（1.167~3.038）］是患者术后3年死亡的相对危险因素（P<0.05），患者采用解剖性肝切除手术方式是患者3年随访生存的保护因素（P<0.05）。 结论： 老年IHCC患者术后生存受到多种因素的影响，但是采取解剖性肝切除术治疗有利于延长患者的生存时间。.