仅保留门静脉血供的肝门部胆管癌根治术

Radical resection of hilar cholangiocarcinoma with portal vein inflow only

目的探讨仅保留门静脉血供的肝门部胆管癌根治术的适应证和方法，以进一步提高肝门胆管癌的治疗效果。方法对2006年7月至2007年12月收治的6例肝门部胆管癌，均采取左半肝切除、肝外胆管切除、肝动脉切除、右肝管空肠吻合术。结果6例均顺利恢复，术后发生胆漏1例、无肝功能衰竭及围手术期死亡病例；术后随访10～23个月，均存活。结论仅保留门静脉血供的肝门部胆管癌根治术在严格掌握适应证的前提下是可行的，可提高肝门部胆管癌的根治切除率，改善患者预后。

Objective To investigate the indications and methods of retaining only portal vein for the hilat cholangiocarcinoma radical resection to improve the therapeutic efficacy. Methods Six patients with hilar cholangiocarcinoma underwent left hepatectomy and extrahepatic bile duct excision. Tumor invaded hepatic artery was resected and right hepatic duct-jejunum anastomosis was made during July 2006 to December 2007. Results There was no mortality. Bile leakage developed in one case and was cured by drainage. No liver failure developed postoperatively. All 6 cases were followed up for 10 -23 months, and all were still alive. Conclusions Retaining only portal vein for the treatment of hilar eholangiocarcinoma radical resection under definite indications is safe.