不能切除的胆管癌的胆道引流术（附80例临床分析）

Surgical biliary drainage for unresectable bile duct cancer: a report of 80 cases

目的：了解胆道引流治疗不能切除的胆管癌的治疗效果。方法：分析经胆道引流手术治疗的不能切除的胆管癌80例的临床资料及生存情况，其中肝门部胆管癌49例（61.3％），胆总管中上段癌9例（11．2％），胆总管下段癌22例（27．5％）.手术方式包括胆肠吻合的内引流术，U或T管外引流，或两者联用。结果：15％的病例术后早期出现并发症，手术死亡率为10％。术后随访：肝门部胆管癌、胆总管中上段癌及胆总管下段癌中位生存期分别为6．10、5．50和9．50个月。胆总管中上段癌无1年以上生存者，肝门部胆管癌和胆总管下段癌1、2、3年生存率分别为27．39％、38．54％，6．59％、8．97％和2．10％、0。结论：胆道引流手术是治疗不能切除胆管癌的一种重要方法，可获良好的姑息治疗效果。

To evaluate the therapeutic effect of surgical binary drainage for unresectable bile duct cancer.Method The clinical data and postoperative survival of 80 cases of unresectable bile duct cancer undergone surgicalbiliary drainage were analysed retrospectively. of them there were 49 hilar cholangiocarcinomas (61. 3%), 9 proximalcommon bile duct cancers (11. 2%) and 22 distal common bile duct cancers(27. 5%). The surgery for binary drainage used inour series included bilioenteric anastomosis, T or U tube drainage, or in combination. Result 12 patients (15%) hadcomplications at early postoperative period, and 8 patients(10%) died within 30 days after operation. Median survivaltime was 6.10 months for hilar cholangiocarcinomas, 5. 50 months for proximal common bile duct cancers, and 9.50months for distal bile duct cancers. No patient with proximal common bile duct cancer was alive for more than 1 year,and 1-year,2-year and 3-year survival rates of hilar cholangiocarcinoma and distal bile duct cancer were 27. 39%,38. 54 %;6. 59%, 8. 97%; and 2.10%,0 respectively. Conclusion Surgical binary drainage plays an important role inrelieving symptoms,improving life quality and prolonging life time for unresectable bile duct cancer.