肝门部胆管癌的外科治疗

Surgical treatment of hilar cholangiocarcinoma

目的 探讨肝门部胆管癌的诊断和外科治疗的效果。方法 对 46例肝门部胆管癌的临床资料进行回顾性分析。结果 本组术前误诊率 43 .5 % (2 0 / 46)。 18例手术切除 ,总手术切除率 3 9.1%(18/ 46) ,其中根治性切除率 2 6.1% (12 / 46) ;2 2例行周围胆管空肠吻合术 ;6例U管引流术。根治切除、姑息切除、胆管空肠吻合和U管引流组病人的平均生存期分别是 (2 0 .3 2± 11.2 4)月 ,(18.12±10 .43 )月 ,(12 .46± 8.78)月和 (7.3 2± 5 .2 4)月。切除组病人的生存期显著长于姑息性手术组 (P<0 .0 1) ,而且生活质量显著提高。结论 临床医生应重视肝门部胆管癌的早期诊断。根治切除术可显著延长患者生存期和改善生存质量。

Objective To study the diagnosis and surgical treatment effects on hilar cholangiocarcinoma. Methods A retrospective analysis was made on the clinical data of 46 patients underwent operation for hilar cholangiocarcinoma. Results The preoperatively misdiagniosis rate was 43.5%(20/46).The total resection rate was 39.1%(18/46), the radical resection rate 26.1%(12/46) .The patients' survival-time of radical resection was increased and the life quality also improved significantly than that of palliative surgical procedure. Conclusions Early disgnosis of hilar cholangiocarcinoma should be emphasized.Radical resection definitely prolongs the survival period and improve the life quality of the patients.