原发性肝癌伴胆管癌栓的外科治疗

SURGICAL TREATMENT OF PRIMARY HEPATOCELLULAR CANCER WITH CANCER THROMBI IN THE BILE DUCT

目的探讨伴胆管癌栓的原发性肝癌(HCC)外科治疗方式的选择及对预后的影响.方法回顾性分析2000～2004年12例HCC伴胆管癌栓的外科治疗情况.结果所有12例患者中,术中死亡1例.发生胆道出血,经保守治疗而愈2例.平均存活时间为7个月,其中肿瘤切除组存活10～30个月,肿瘤未切除引流组术后存活4～10个月.结论原发性肝癌伴胆管癌栓行外科治疗是一种积极有效的治疗方法.

Objective To evaluate surgical therapy and the effect for primary hepatocellular carcinoma （HCC）with tumor thrombi in the bile duct. Methods From 2000 to 2004 , 12 patients with HCC and bile duct thrombi（BDT） who underwent surgical intervention were retrospectively analyzed. Result Among all the patients, one patient died during operation, two patients occurred hemobilia, and cured after conservative therapy. All discharged patients were followed up for up to one year. The average survival time was 7 months. Among all patients,tumor resection group survival 10- 30 months, tumor non-resection,but drainage group survival 4- 10 months,Conclusion Hepatectomy plus the clearance of tumor thrombi from bile duct was effective for patients with HCC and BDT.