肝门部胆管癌45例手术治疗分析

Surgical Treatment for Hilar Cholangiocarcinoma:Analysis of 45 Cases

目的：探讨影响肝门部胆管癌术后疗效的手术治疗策略。方法：对2007年1月-2012年1月笔者所在医院通过手术治疗的45例肝门部胆管癌进行回顾性分析。其中单纯探查组3例,置管外引流组15例,胆肠内引流组13例,根治性切除组14例,比较各组术后生存时间。结果：3例患者经探查后发现已失去进一步手术机会,相继于术后1~3周发生肝功能衰竭而死亡。置管外引流组平均生存时间为11.5个月;胆肠内引流组平均生存时间为15.4个月;根治性切除组平均生存时间为22个月。根治性切除组与引流组术后生存时间比较差异有统计学意义（P〈0.05）。结论：对于无法根治的肝门部胆管癌患者,姑息性肿瘤切除和引流术也可以延长患者的生命。根治性切除仍然是治疗肝门部胆管癌的首选方法。

Objective： To assess the therapeutic strategies and prognostic factors that could influence the clinical out-come of hilar cholangiocareinoma （ HCC ） .Method： A retrospective study was conducted on 45 cases of HCC.Ineluding, Exploration of operation 3 cases, Catheter drainage group 15 cases, Biliary enteric drainage group 13 cases, 14 cases of radical resection group.The groups were compared the postoperative survival time.Result： 3 cases lost the chance of operation after the exploration, 1 or 3 weeks later they died of hepatic failure.Catheter drainage group mean survival time of 11.5 months： biliary enteric anastomosis group the mean survival time of 15.4 months： radical resection group the mean survival time of 22 months. The difference that Radical resection group and drainage group postoperative survival time compared was statistically significant.Conclusion： Palliative resection or drainage procedures can effectively prolong the incurable patient＇s life.Radical resection is the treatment choice for hilar cholangiocareinoma.