肝门部胆管癌手术治疗的难点与处理技巧

Operative techniques for puzzles in surgical treatment of hilar cholangiocarcinoma

目的探讨手术治疗肝门部胆管癌的手术难点及处理技巧。方法总结2002年1月～2006年6月手术治疗的31例肝门部胆管癌的临床资料、手术难点与对策。结果31例均获得根治性或姑息性切除,其中行肝方叶切除11例,左肝外叶切除5例,左半肝切除4例,右半肝切除3例,尾状叶切除6例,全组术后肝功能均有不同程度改善,无围手术期死亡。结论严格遵循手术治疗原则,改进手术技巧,可提高肝门部胆管癌的手术切除率,并获得较好的近期疗效。

[Objective] To explore the puzzles and corresponding techniques in the surgical treatment of hilar cholongiocarcinoma. [Methods] The clinical data, operative puzzles and countermeasures of hilar cholongiocarcinoma in 31 patients, who underwent surgical treatment in from January 2002 to June 2006, were retrospectively summarized. [Results] Radical or palhative resection was performed in 31 cases. Quadrate lobectomy was performed in 11 cases, left external lobectomy in 5 cases, left lobectomy in 4, right lobectomy in 3 and caudate lobectomy in 6. Postoperative parameters of hepatic function improved to some extent. No perioperative mortality occurred. [Conclusion] To follow operative principles strictly and improve operative techniques can elevate the resection rate and obtain short-term curative effect.