肝右三叶切除并门静脉切除和重建治疗肝门胆管癌

Treatment of Hilar Cholangiocarcinoma with Right Hepatic Trisegmentectomy and Portal Vein Resection and Reconstruction

目的总结肝右三叶切除并门静脉切除和重建在肝门部胆管癌中应用的临床经验.方法 BismuthⅢa型肝门部胆管癌患者1例,肿瘤侵犯门静脉右支及分叉处,进行肝右三叶切除联合门静脉重建根治性切除肿瘤.结果手术过程顺利,完整切除肿瘤,术中出血约500 mL,未输血;术后恢复良好,第13天出院;术后6月复查未见肿瘤复发与转移,病人精神及身体状况良好,现在仍存活.结论肝门胆管癌患者有可能直接耐受联合右三叶切除及门静脉重建.

Objective To summarize the clinical experience of the right hepatic trisegmentectomy and portal vein resection and reconstruction in hilar cholangiocarcinoma.Methods One case of hilar cholangiocarcinoma with tumor invasion of portal vein right branch of the bifurcation(Bismuth type Ⅲ)was selected.Right hepatic trisegmentectomy with portal vein reconstruction of radical resection of the tumor was performed for the patient.Results The process of the surgery went smoothly,the tumor was completely resected,blood loss was 500 mL,no blood transfusion was needed.The patient was discharged at the 13th days after operation.No tumor recurrence and metastasis were discovered at 6 months after opertaion.Conclusion The joint right trisegmentectomy and portal vein reconstruction probably is a way of treatment for hilar cholangiocarcinoma Bismuth type Ⅲ.