联合门静脉切除的肝门部胆管癌根治切除术及远期疗效观察

Following of combined portal vein resection in the treatment of the hilar cholangiocarcinoma

目的观察联合门静脉切除在肝门部胆管癌治疗中的远期治疗效果。方法总结2000年3月至2005年3月收治的38例肝门部胆管癌的临床资料。结果 38例中浸润门静脉的15例肝门部胆管癌行联合门静脉切除胆管癌根治术,其中门静脉分叉部联合左半肝切除4例,门静脉主干切除7例,门静脉侧壁切除修补术4例。术后因肝肠吻合口漏、肝功能衰竭死亡1例,其余14例术后随访平均生存(31.40±3.44)个月。未浸润门静脉的肝门部胆管癌23例行肝门胆管癌根治术,术后平均生存(34.04±4.43)个月。两组生存期差异无统计学意义(P>0.05)。结论肝门胆管癌浸润门静脉不是肿瘤切除的禁忌证。联合门静脉肝门胆管癌切除术可提高肝门部胆管癌的治愈切除率,并可获得较满意的远期生存。

Objective To observe the role of portal vein excision in the treatment of hilar cholangiocarcinoma and to improve the treatment effect.Methods 38 patients with hilar cholangiocarcinoma from May 2000 to May 2005 were analysis retrospectively.Results Of 38 patients with hilar cholangiocarinoma,15 patients were performed operative resection combined with portal vein,including 4 patients resection furcation of portal vein and left liver,7 patients suffered portal vein resection and 4 patiens were performed resection part lateral wall of portal vein.1 patient died of leak of anastomosis and hepatic function failure,the others were followed up,the average the long-term survival was （31.40±3.44） months,the control group including 23 patients with no portal invation,the average the long-term survival is （34.04±4.43） months.Conclusions Combined portal vein resection may raise the radical resection rate of hilar cholangiocarcinoma and improve the prognosis after operation.