肝门部胆管癌的外科治疗

Surgical treatment for hilar cholangiocarcinoma

目的 评价肝门部胆管癌手术治疗效果。方法 回顾性分析 4 0例肝门部胆管癌的临床资料。结果 4 0例胆管癌中 ,11例行治愈性切除术 ,10例行姑息性切除术 ,19例行内外引流术 ,手术切除率为 5 2 .5 %。根治术者 1、3、5年生存率为 82 .5 %、2 5 %、15 .5 % ,姑息性切除 1、3年生存率分别为 35 .5 %和 9.5 %。非切除性胆道内、外引流者生存期均未超过 2年 ,1年生存期分别为 3/ 11和 2 / 8,无 2年生存者。术后并发症 15例 (37.5 % ) ,术后死亡率 7.5 % (3/ 4 0 )。结论 治愈性切除是治疗肝门癌胆管最佳手段 ,姑息性切除也能延长病人生存时间。

Objective To evaluate the effect of surgical treatment of hilar cholangiocarcinoma. Methods The clinical data of 40 cases with hilar cholangiocarcinoma were reviewed. Results Of the 40 patients, 11 cases underwent radical resection, 10 cases were treated by palliative resection, 19 cases were subjected to nonresectional internal or external drainage. The resection rate was 52.5%. In the radical resection group, the 1～,3～,5～year survival rate was 82.5%?25% and 15.5% respectively; in the palliative resection group, the 1～,3～year survival rate was 35.5% and 9.5%; whereas in the nonresection group, the 1～year survival rate of internal drainage was 25.5%, and 24% in external drainage. None in the patients of the nonresection group survived for over 2 years. Postoperative complication occurred in 15 cases. The perioperative mortality was 7.5%. Conclusion Radical resection is the most effective method for hilar cholangiocarcinoma, and palliative resection also can prolong survival.