原发性肝癌伴梗阻性黄疸15例原因分析及处理

Surgical treatment and analysis of the obstructive jaundice caused by primary liver cancer in 15 cases.

目的 探讨不同类型原发性肝癌伴梗阻性黄疸的原因及其治疗方法。方法 分析原发性肝癌伴梗阻性黄疸的病人 15例 ,其中肝癌引起胆管癌栓 7例 ,肝癌压迫或侵犯肝门部胆管 8例。其中手术 10例 ,清除肝癌原发灶 ,解除胆管梗阻。非手术 5例 ,先行减轻黄疸处理 ,然后行TAE、PEI等综合治疗。结果 手术切除病灶 ,延长生存期 ,而非手术处理组也明显改善症状 ,疗效显著。随访 12 4个月 (平均 9个月 ) 3例死亡 ,12例仍存活。结论 临床上有必要对原发性肝癌伴梗阻性黄疸进行积极治疗 ,以改善生活质量 。

Objective To investigate the reasons and therapies of the obstructive jaundice caused by primary liver cancer in different groups.Methods Fifteen patients with obstructive jaundice caused by hepatocellular carcinoma were treated. Of them 7 suffered from the liver carcinoma accompanied by cancer thrombi in the bile duct, the others had the liver carcinoma which had eroded or pressed the hepatic hilar bile duct.Ten patients who had undergone surgery were dealt with removal of tumor focus and alleviation of obstruction, while non-operative 5 patients were treated first with alleviation of jaundice and then comprehensive therapy of TAE, PEI, et al.Results The intensive surgical operation prolonged life-span, and the non-operation treatment also showed the effect of obviously relieving symptoms of jaundice. In these patients the outcome was as follows:3 died of recurrent HCC during the follow-up of 1~24 months, while 12 are still alive.Conclusion It is necessary to treat the primary liver cancer accompanied by obstructive jaundice to prolong survival time and improve life quality.