肝门部胆管癌25例外科治疗的选择

目的：探讨肝门部胆管癌的手术方式及手术要点。方法：回顾性分析经手术和病理证实的25例肝门部胆管癌临床特点，手术方式和随访结果。结果：本组手术切除11例，余14例均行胆汁内，外引流术，其中胆肠内引流术9例，外引流术5例。随访手术切除病人1．0，1．5，2．0年生存率分别为54．6％（6／11），45．4％（5／11），18．1％（2／11），最长存活11年；引流组病人1年生存率仅35．7％（5／14），结论：肝门部胆管癌应力争根治性切除，不能切除者应行内引流术，但对于医疗条件较差的医院，则可行外引流术，延长病人生命，提高生存质量。

The Choice of Surgical Therapy of Hilar Cholangiocarcinoma

Objective:To evaluate the focus on surgical treatment of hilar cho langiocarcinoma. Methods:Clinical data about clinical character,operation mode l and prognosis of 25 patients with hilar cholangiocarcinoma admitted into our h ospital between 1958 and 2000 were retrospectively analyzed.The diagnosis was co nfirmed by pathology.Results:The tumor of 11 cases with cholangiocarcinoma was resected (44%).The other 14 cases,which were no resected were done with intern al or external drainage.In the resected group,the 1.0,1.5 and 2.0 year surviva l rates were 54.6%,45.4%,18.1%respectively,and the longest survival is abo ve 11 years now,whereas the survival rate was only 35.7%in 1 year of non-rese cted group.Conclusions:Radical resection should be accomplished if it is feasib le;cholangioenterostomy is another choice for patient in which tumor resection can not be performed.