93例肝门胆管癌外科治疗与预后分析

Analysis of Surgical Treatment and Prognostic Factors for 93 Cases Hilar Cholangiocarcinoma

目的探讨肝门胆管癌的外科治疗与预后。方法回顾性分析我院自1999年6月-2005年6月93例肝门胆管癌患者的外科治疗情况,并分析影响其预后的因素。结果93例肝门胆管癌病人中根治性切除52例,姑息性切除21例,行外引流术9例,开腹内引流术11例。根治性手术切除组的中位生存期31个月,其他治疗组的中位生存期分别为13、7、11个月。年龄、血清总胆红素、临床分型、肿瘤分化程度及有无淋巴结转移是影响术后患者预后的重要因素。结论肝门胆管癌的治疗以手术切除治疗为主,根治性切除治疗的预后明显优于其他。年龄、血清总胆红素、临床分型、肿瘤分化程度及有无淋巴结转移等对预后也有显著的影响。

Objective To explore surgical treatments and the prognosis of hilar cholangiocarcinoma. Methods The surgical treatments of 93 cases from June 1999 to June 2005 in our hospital were analyzed in retrospective study,and the prognostic factors were analyzed. Results In the 93 eases,52 cases underwent radical resection,21 cases palliative resection,9 eases non-operative draining. 11 cases palliative draining operations. The median survival time was 31 months in radical resection group,it was 13,7 and 11 months in other groups respectively. The patient age,serum total bilirubin,clinical standard,tumor differentiation and lymph node metastases were important factors to predict the prognosis of hilar cholangiocarcinoma patients. Conclusion Resection was the main treatment for hilar cholangiocarcinoma,and the curative resection was the best way to obtain better prognosis, age,serum total bilirubin,clinical standard,tumor differentiation and lymph node metastases were considered to have significant effect on prognosis.