32例肝门胆管癌的手术治疗

目的：讨论肝门胆管癌的手术经验。方法：对1997年9月至2002年11月行手术治疗的32例肝门胆管癌患者的临床资料进行回顾性分析。结果：32例中行胆管癌根治术10例，引流术12例，探查活检、肝动脉置泵化疗及姑息性手术10例。手术均顺利完成，术后肺部感染4例，胆道感染l例，住院期间死亡2例。结论：肝门胆管癌应积极手术，对不能切除的患者可以进行胆道引流术或外科旁路手术，不能手术的患者可以选择肝动脉灌注化疗。

The Surgical Treatment of Hilar Cholangiocarcinomas:Report of 32 Patients

Objective:To discuss the experience of surgical treatment of hilar cholangiocarinomas.Methods:The clinical date of 32 cases with hilar cholangiocarinomas treated with surgical intervention from September 1997 to November 2002 were retrospectively analyzed.Results:Thirty-two cases were operated including radical excision 10 cases,drainage 12 cases and exploration,biopsy,hepatic artery perfusion chemotherapy or palliative operation radical excision.All operations were carried out successfully.The postoperative complications were pulmonary infection 4 cases and bilary duct infection 1 case.Two cases were died in the hospital.Conclusion:Radical excision was the first selection of the treatment of the hilar cholangiocarcinomas.The patients of late stages should be treated with bile duct drainage,by-pass operation or hepatic artery perfusion chemotherapy.