合并胆道癌栓原发性肝癌的外科治疗

Surgical Treatment of Primary Hepatocellular Carcinoma Complicated with Bile Duct Embolus

目的 探讨合并胆道癌栓原发性肝癌的临床特点及外科治疗。方法 回顾性分析胜利油田中心医院自1992年 10月至 2 0 0 2年 10月手术治疗的 2 80例肝癌患者 ,其中 11例合并有胆道癌栓的患者均行外科治疗并进行分析总结。结果 合并胆道癌栓的患者占同期肝癌患者的 3 9% (11/2 80 ) ,患者术前诊断率为 5 4 5 % (6 /11)。手术分别采取局部切除或肝段切除加胆总管切开取栓“T”管引流术及其它相应的姑息性治疗措施。中位生存时间为 14个月左右 ,最长已达 4 2个月。结论 合并胆道癌栓的肝癌并非都是晚期表现 ,如及早地诊断及外科治疗能改善胆道癌栓肝癌患者的生存质量。

Objective To explore the clinical features and surgical treatment of hapatocellular carcinoma complicated with biliary tumor thrombi. Methods From Oct. 1992 to Oct. 2002, among the 280 patients subject to hepatectomy for hepatocelluar carcinoma, 11 had bile duct thrombi with obstructive jaundice and subjected to surgical treatment. They were retrospectively analyzed.Results The diagnosis ratio of the patients was 54 5 % (6/11) before operation. All the 11 patients complicated with biliary tumor thrombi received local hepatecotomy or segmentectomy in combination with tumor thrombectomy through a choledochotomy and other palliative treatment. The median survival time was about 14 months. The longest one was 42 months. Conclusion Macroscopic biliary tumor thrombi from HCC do not imply a dismal prognosis. Early detection and surgical treatment can approve the living quality of HCC patients complicated with biliary thrombi.