肝门部胆管癌59例外科诊治分析

目的探讨肝门部胆管癌的临床诊断和外科治疗方法。方法对某院2004年1月～2009年12月收治的59例肝门部胆管癌的临床资料进行回顾性分析。结果按Bismuth-Corlette临床分型:Ⅰ型7例,Ⅱ型9例,Ⅲa型11例,Ⅲb16例Ⅳ型16例。根治性切除29例,姑息性切除9例,内引流术11例;单纯置管外引流术5例;剖腹探查仅行腹腔病灶活检术2例,非手术治疗3例。根治性切除者,平均生存期为26.2月;姑息性切除者,平均生存期为14.2个月;仅行内外引流术者,平均生存期为13.9月;非手术治疗者,平均生存期4.2月。结论肝门部胆管癌的诊断主要依靠影像学检查及肿瘤标志物,手术治疗是肝门部胆管癌的首选治疗方法。

Analysis of diagnosis and surgical treatment of hilar cholangiocarcinoma in 59 cases

OBJECTIVE To investigate the clinical diagnosis and surgical treatment for hilar cholangiocarcinoma.METHODS The clinical data of 59 cases of hilar cholangiocarcinomas in our hospital during January 2004 to December 2009 were retrospectively anslyzed.RESULTS According to Bismuth-Corlette clinical type:7 cases in type Ⅰ,9 cases in type Ⅱ,11 cases in type Ⅲa and 16 cases in type Ⅲb.29 cases took radical resection,9 cases took palliative resection,11 cases had internal drainage;5 cases took simple external drainage;2 cases had laparotomy biopsy.3 cases got in-operation treatment.The mean survival time of radical resection patients was 26.2 months;palliative resection patients,the mean survival time was 14.2 months;The mean survival time was 13.9 months for only-drainage patients.The mean survival time was 4.2 months for non operation therapy.CONCLUSION The diagnosis of hilar cholangiocarcinoma mainly depends on imaging checks and tumor marker,operation is the preferred choice for treatment of hilar cholangiocarcinoma.Operation of hilar bile duct cancer treatment is the optimal method of treatment