手术切除治疗肝门部胆管癌

目的 总结肝门部胆管癌手术治疗的经验.方法 回顾性分析本院9年因肝门部胆管癌行手术切除的83例病人的临床资料和随访结果.结果 83例手术切除病人中行根治性切除（R0）31例,非根治切除52例（R1,R2）,术后出现并发症29例,死亡5例.根治性切除组中位生存期21.5个月,1、3、5年生存率分别为79.6%,43.3%和25.9%,明显优于非根治性切除组（P＜0.05），近5年本院根治性切除率达44.8%,中位生存期18.7个月,疗效明显提高（P＜0.05），结论 加强围手术期处理、术中行切缘冰冻病理检查、联合肝切除等可提高肝门部胆管癌根治性切除率、减少并发症和死亡率;根治性切除可更好延长病人生存期,使手术治疗肝门部胆管癌获得良好的疗效.

Surgical resection for hepatic hilar cholangiocarcinoma

Objective To summarize the experience in surgical resection for hepatic hilar cholan- giocarcinoma.Methods The clinical and follow-up data of 83 patients with hepatic hilar cholangiocar- cinoma receiving surgical resection in our hospital in the past 9 years were retrospectively analyzed. Results Of the 83 patients,31 underwent radical resection and 52 palliative resection.After the oper- ation,29 patients had complications and 5 died.In the radical resection group,the median survival time was 21.5 months and the 1-,3-and 5-year survival rates were 79.6%,43.3% and 25.9%,re- spectively,which were significantly higher than those in the palliative resection group(P<0.05).In recent 5 years,the rate of tumor radical resection has increased from 25% to 44.8% and the median survival time from 12.1 to 18.7 months(P<0.05).Conclusions Improvement of patient preopera- tive condition,pathological examination during the operation and combined liver resection may help in increasing the radical resection rate and reducing postoperative morbidity and mortality.The radical resection can prolong and improve the survival time of the patients and ensure the better outcome.