肝门部胆管癌的手术治疗:附102例报告

Surgical treatment of hilar cholangiocarcinoma:a report of 102 cases

目的探讨肝门部胆管癌的手术治疗方式。方法回顾性分析1 9 9 0年8月—2 0 0 3年8月我院收治的1 0 2例肝门部胆管癌的临床资料。结果1 0 2例肝门部胆管癌中,5 8例(5 6.9%)行手术切除,其中2 7例(2 6.5%)行根治性切除,3 1例(3 0.4%)行姑息性切除;4 4例(4 3.1%)行胆管引流术,其中行胆肠吻合内引流术2 0例,胆管外引流术2 4例。根治性切除术组1,2,3,5年生存率分别为8 8.8 9%,5 1.8 5%,3 7.0 3%,2 2.2 2%;姑息性切除术组1,2,3,5年生存率分别为51.61%,6.4 5%,3.2 2%,0%;胆肠吻合内引流术组和胆管外引流术组的1年生存率分别是29.41%和2 3.8 0%,无生存2年者。结论手术切除,特别是根治性切除治疗肝门部胆管癌可取得较好的疗效。

Objective To evaluate the method of surgical therapy of hilar cholangiocarcinoma. Methods The clinical data of 102 surgically treated patients with hilar cholangiocarcinoma admitted into our hospital from August 1990 to August 2003 were retrospectively analyzed. Results In this cohort of 102 cases of hilar cholangicarcinoma ,58 cases（ 56.9% ） underwent sugical resection. In 27 （ 26.5% ） of these 58 cases, a radical resection was performed, and 31 cases （ 30. 4 % ） had a palliative resection. Bile duct drainage was done in 44 cases （43. 1% ） , that included 20 cases with internal drainage by cholangioenterostomy and 24 cases with external biliary drainage. The 1 - , 2 - , 3 - and 5 - year survival in the radical resection group was 88.89% ,51.85% ,37.03% and 22. 22% ,respectively,and in the palliative resection group was 51.61% ,6.45%, 3. 22% and 0%, respective. In the cholangioenterostomy internal drainage group and the external biliary drainage group, the 1 - year survival rate was 29.4% and 23. 80% , respectively, and there were no 2 - year survivors. Conclusions Better treatment results for hilar cholangiocarcinoma can only be obtained by surgical resection, especially by radical resection.