肝门部胆管癌的诊断和外科治疗

DIGNOSIS AND SURGICAL TREATMENT OF HILAR CHOLANGIOCARCINOMA

目的探讨肝门部胆管癌的诊断方法和外科治疗。方法回顾性分析106例肝门部胆管癌患者临床资料。根治性切除术33例,姑息性切除27例,内和外引流46例。结果应用核磁共振胰胆管成像对肝门部胆管的定位及定性诊断准确率达到98%。手术病死率9.4%,各组间无显著差异;手术切除率52%,其中根治性切除率34%;内引流率33%;外引流15%。根治性切除、姑息性切除、内引流和外引流组术后中位生存时间(月)30、17、13、2.9。结论应用磁共振胰胆管成像对肝门部胆管癌的定位及定性诊断率高。根治性切除是影响肝门部胆管癌患者疗效的主要因素,对无法行根治性切除者以内引流为首选治疗方法,能提高患者术后生活质量,延长生存期。

Objective To study the diagnosis and surgical therapy for hilar cholangiocarcinoma. Methods Retrospective study was performed in 106 cases of hilar cholangiocarcinoma were analyzed. 33 received radical resection, 27 were palliative resection, 46 were internal or external drainage procedures. Results Hilar cholangio-carcinoma were diagnosed by imaging of MRCP. the diagnosis accuracy rate was 98%. The operative mortality rate was 9. 4% ,there was no significant difference between the groups. Tumor resection rate of 52%, including radical resection rate of 34%, internal drainage rate of 33%, external drainage rate of 15%. The mean survival time was 30 months, and 17 months, and 13 months,and 2.9 months for the total 96 patients who received radical resection, palliative resection,internal drainage group, and external drainage group. Conclusion MRCP have high accurate in the giagnosis of the locationand nature of hilar cholangiocarcinoma curative resection are the main related factors influencing the therapy efficacy hilar cholangiocarcinoma, internal drainage is first choice for palliative operation, It is effective in relieving symptoms and prolonging Lifespan.