肝门部胆管癌外科治疗的临床研究

The clinical analysis of surgical therapy for hilar cholangiocarcinoma

目的探讨肝门部胆管癌外科切除的临床价值。方法回顾性分析49例肝门胆管癌病例的临床资料,观察手术方式与患者预后的关系。结果本组49例肝门部胆管癌患者中,根治性切除27例(55.1%),姑息性切除14例(28.6%),无法切除8例(16.3%);根治切除组1、3、5年生存率分别为66.7%,40.7%,25.9%;姑息性切除组1、3、5年生存率分别为28.6%,7.1%,0.0%;无法切除组1年生存率仅为12.5%。术后并发症:胆漏3例(根治性2例,姑息性1例),消化道出血1例。结论肝门部胆管癌的外科切除优于其他治疗方式,而根治性切除是提高生存率的有效方法。

Objective To investigate the clinical value of surgical resetting for hilar cholangiocarcinoma. Methods The clinical data of 49 patients with hilar bile duct carcinoma was analyzed retrospectively, and the relationship between operative procedures and patients prognosis was observed. Results Among 49 patients with hilar cholangiocarcinoma,27 cases （55.1% ） underwent radical resection, 14 cases （28.6%） underwent palliative resection, and 8 cases （ 16. 3 % ） missed the chance of surgical resection. The cumulative survival rates at the 1 st ,3rd and 5th year after radical resection were 66. 7% ,40. 7% , and 25.9% respectively, but that of palliative resection were 28.6% ,7.1% and 0.0% respectively（ P 〈 0. 05 ） ; survival rates at the 1 st in no-operative group was only 12. 5%. Postoperative complications：3 cases developed bile leakage, including radical resection 2 cases and palliative resection 1 cases; 1 case developed digestive tract bleeding. Conclusion The surgical resection of hilar cholangiocareinoma surpasses the other therapy, and radical resection is an effeetive methods of improving survival rate.