肝门胆管癌103例诊治分析

The diagnosis and treatment analysis of 103 cases with Hilar cholangiocarcinomas

目的:探讨不同方法治疗肝门胆管癌的预后及其影响因素。方法:103例肝门胆管癌患者中行根治性切除28例,姑息性切除12例,经皮经肝胆管引流术(PTCD)+经皮胆道支架植入术34例,仅行PTCD术29例。结果:4种手术患者中位生存期分别为(26.00±1.51)个月、(16.00±1.49)个月、(12.00±1.83)个月和(5.00±1.49)个月,差异有统计学意义(P<0.01);Bismuth分型、有无淋巴结转移及是否术中化疗均影响患者预后。结论:根治性手术切除是肝门胆管癌的最佳治疗方法。Bismuth分型、有无淋巴结转移及是否术中化疗是影响预后的重要因素。

Objective：To explore the surgical treatment of hilar eholangiocarcinoma and its prognosis factors. Methods：The clinical data of 103 cases with hilar cholangiocarcinoma were analyzed retrospectively. Among 103 cases, 28 cases were treated with radical resection,12 cases were treated with palliative resection, 34 cases were treated with percutaneous transhepatic eholangial drainage （PTCD） combined with percutaneous biliary stent implantation and 29 cases were treated with PTCD. Results：Their median survival time were（26.00 ± 1.51 ）, （ 16.00 ± 1.49 ）, （ 12.00 ± 1.83 ） and （ 5.00 ± 1.49 ） months, respectively, the time differences had statistical signifieance（P 〈 0.01 ）. The Bismuth type,lymph node metastasis and intraoperative chemotherapy affected the prognosis of patients with hilar cholangiocarcinoma. Conclusions：Radica resection is the best treatment for hilar cholangioearcinoma. The Bismuth type,lymph node metastasis and intraoperative chemotherapy are important influence factors for the prognosis.