肝门部胆管癌的外科治疗35例疗效分析

Clinical Analysis with Surgical Treatment for Hilar Cholangio Carcinoma: A Report of 35 Cases

目的探讨肝门部胆管癌外科治疗术式的选择和效果。方法对手术治疗35例肝门部胆管癌的临床资料进行总结,包括临床表现、手术方式、临床分型、治疗效果。结果无痛性梗阻性黄疸者占62.8%,切除组术后2周TB和AKP水平较其他两组下降明显;根治性切除8例,姑息性切除10例,引流减黄手术17例;肿瘤切除者1、3年生存率分别为83.3%、22.2%,单纯引流者1、3年生存率为58.8%、0;肿瘤切除明显优于单纯引流(P<0.05)。结论手术治疗是提高肝门部胆管癌远期生存率及改善生活质量的关键,简化术前检查,力求早期手术,争取肿瘤切除。

Objective To investigate the selection and effect of surgical treatment for hilar cholangio carcinoma. Methods 35 patients with hilar cholangio carcinoma underwent surgical treatment from June 1992 to July 2005. The results were analyzed retrospectively, including clinic characteristics, operation pattern, effect of treatment. Results 62.8% of patients were characteristic with non-pain jaundice. 8 cases underwent radical resection and 10 cases underwent palliative resection. 17 cases were subjected to non resectional internal or external drainage. In the resection group, the 1,3-year survival rates were 83.3% ,22.2%. In the drainage group,the l-year survival rate was 58.8% and nonsurvived for over 3 years. Conclusion Surgical treatment is a major procedure for the management of hilar cholangiocarcinoma. Early operation is recommended after necessary and simplified examination, and tumor resection is associated with favorable outcome.