高位胆管癌71例临床分析

High bile duct carcinoma:a clinical analysis of 71 cases.

目的 分析 71例高位胆管癌治疗方法和生存时间。方法 高位胆管癌切除者行高位胆肠Roux -en-Y吻合术 ,未切除者行胆汁内或外引流术并标记肿瘤部位且置管行术后腔内照射 ,未手术者行PTCD内或外引流并行腔内或体外照射。结果 共有 2 1例予以切除 ,15例切除后生存在 2 4个月以上 ,4例死于 15个月内。其余 5 0例生存 4～ 18个月。结论 高位胆管癌外科手术治疗是主要手段 ,腔内照射及肝动脉化疗栓塞 ,可预防或延迟局部复发及转移 。

Objective To analyze the treatment choice and survival of high bile duct carcinoma.Methods High bile duct cholangio jejunal anastomosis were performed after resection of high bile duct carcinoma,internal or external biliary drainage and canals for internal radiation were placed in patients whose tumor couldn't be excised,and PTCD was performed with internal or external radiation in those unfitted for operation.Results 15/21 tumor excised patients have survived longer than 24 months,whereas 4/21 died within 15 months.The other 50 cases have survived for 4～18 months.Conclusion Surgery is the primary therapeutic method of high bile duct carcinoma,while internal radiation and TAE can prevent or delay the relapse and metastasis and prolong the survival.