肝门血管骨骼化应成为T3，T4胆囊癌手术治疗的常规步骤

 目的 探讨肝门血管骨骼化胆囊癌根治术或扩大根治术对T3，T4胆囊癌的治疗价值。方法 在连续收治的胆囊癌患者中，对16例术前或术中确诊的T3，T4胆囊癌随机分无肝门血管骨骼化的胆囊癌根治术或扩大根治术（n = 9）、肝门血管骨骼化胆囊癌根治术或扩大根治术（n = 7）2组。观察比较患者临床病理特征、术后并发症发生率及生存情况。结果 两组患者年龄、性别分布、并发症发生率均无统计学差异；患者术后中位生存期分别为6和21个月，两组患者术后生存期比较统计学差异极显著（P = 0.003 4），第2组7例患者中2例现仍无瘤生存。结论 肝门血管骨骼化在外科治疗延长T3，T4胆囊癌患者生存中具有重要意义，应成为胆囊癌根治术的常规步骤。

Vascular skeletonization of hepatic hilum should be an essential procedure in surgical treatment of T3,T4 gallbladder carcinoma

Objective To evaluate vascular skeletonization of hepatic hilum(VSHH)in the treatment of T3,T4 gallbladder carcinoma(GC). Methods Radical/extended radical resection without VSHH(n=9),and radical/extended radical resection with VSHH(n=7) were employed randomly in 16 patients with T3,T4 GC.Clinicopathologic factors,postoperative complications and overall survival of the 2 groups of patients were compared. Results The mean survivals of patients after surgery were 6 and 21 months in the 2 groups respectively.Th...