肝细胞癌合并胆管癌栓患者术中癌栓的处理

Management of tumor thrombus during operation for hepatocellular carcinoma with bile duct tumor thrombus

目的 探讨肝细胞癌（HCC）合并胆管癌栓患者术中癌栓的处理方式和术后恢复过程。方法 对1995年1月-2002年12月手术治疗的27例HCC合并胆管癌栓情况进行回顾性总结和分析。结果 只有59．3％（16／27）患者行肝切除、胆管取癌栓及胆管引流术。全组术后并发症发生率为55．6％（15／27），术后30d病死率为22．2％（6／27）。结论 HCC合并胆管癌栓的预后差，早期诊断和外科手术治疗是改善此病预后的关键。

Objective To explore the management of tumor thrombus during operation and the recovery procedure after operation for hepatocellular carcinoma （HCC） with bile duct tumor thrombus. Methods Restrospective study was performed on the surgical treatment of 27 cases of HCC with bile duct tumor thrombus from January 1995 to December 2002. Results In 27 operated cases, 16 patients （59.3%） received hepatectomy combined with thrombectomy and biliary duct drainage. The operative complication rate was 55.6% （ 15/27）, the mortality within postoperative 30 days was 22.2% （6/27）. Conclusion＇ The prognosis of HCC with bile duct tumor thrombus is poor. Early diagnosis and surgical treatment are the key points to improve the survival time of patients.