老年肝门部胆管癌的临床特点与治疗

Clinical features and therapy of the elderly hepatic portal cholangiocarcinoma

背景与目的：老年肝门部胆管癌的发病率有上升趋势．由于老年人的病理、生理及其病变的解剖特点．手术切除率极低，而以各种引流术辅以术后放化疗为主。本研究探讨老年肝门部胆管癌的临床特点及有效治疗方法。方法：回顾性分析本院1995年1月到2005年12月共收治的28例老年人（≥60岁）肝门部胆管癌的临床资料：结果：共3例行胆管癌切除，术后两例存活超过3年，手术探查3例．存活时间1～2个月，其余22例均行胆道内或外引流，辅以放疗，存活时间在5个月到48个月，平均13．2个月。结论：外科手术仍是治疗肝门部胆管癌的有效治疗手段。对无法切除者，行各种引流手术，辅以放化疗，可以改善患者的生存质量、延长生存时间。

Background and purpose： The morbidity of the elderly patients with hepatic portal cholangiocarcinoma is rising. Due to the characteristics of pathology, physiology and anatomy of the disease, most of the patients with cancer are not resectable, the main treatment consists of the diverting drainage and postoperative chemoradiation. We studied the clinical features and the effective therapeutic method for the elderly patients with hepatic portal cholangiocarcinoma. Methods： A retrospective analysis was performed in 28 cases of the elderly patients with hepatic portal cholangiocareinoma who were treated between January 1995 and December 2005 in our hospital. Results： 3 cases received surgery, 2 of them survived for over three years, another 3 cases were given operative exploration with 14 months of medium survival tlnle. 22 cases were given internal or external drainage and received radiotherapy after operation, their survival time ranged from 5 months to 40 months. Conclusions： Surgery is the primary therapeutic method for elderly patients with hepatic portal cholangiocarcinoma. Internal or external drainage and radiotherapy could prolong survival time of the patients with unresectabke disease.