T管套U管治疗不能手术切除的肝门部胆管癌

目的]探讨用一简便、有效、并发症相对少的方法治疗不能手术切除的肝门部胆管癌。方法]采用自行设计的T管套U管的引流方法治疗不能手术切除的肝门部胆管癌24例,与同期我们用传统的胆肠吻合+U管引流的方法治疗41例相比较。结果]T管套U管组手术时间为45min、手术并发症有3例(12.5％)、术后胆道感染3例(12.5％)。吻合组手术时间为145min,手术并发症有17例(41％),术后胆道感染16例(39％)。该3项指标前者明显优于后者。手术后退黄、手术死亡、中位生存期两组无明显差异。结论]T管套U管手术引流治疗不能手术切除的肝门部胆管癌,手术简单,手术后并发症少,术后胆道感染机会低。

A T Tube Sheathed U Tube Approach for Unresectable Hilar Cholangiocarcinoma

Objective ] To evaluate the effectiveness of T-tube sheathed U-tube approach for unre-sectable hilar cholangiocarcinoma. Methods] T-tube sheathed U-tube for unresectable hilar cholan-giocarcinoma were employed in 24 cases form 1991 to 2001. The clinical data were collected and compared with 41 cases of traditional T-tube drainage plus bilio-jejunal anastomosis. Results] Compared with the group of tranditional anastomosis , patients in the group of T-tube sheathed U-tube had significant shorter mean operation time(45 min vs 145 min, P < 0. 05), decreased morbidility rate (12. 5% vs 41%, P < 0. 05) and fewer chances of postoperative biliary tract infection (12. 5% vs 39%, P < 0. 05). However, there were no signicant differences between these two groups in mortality rate(4. 2% vs 9.8% , P> 0. 05) and survival time(8 months vs 7.2 months, P> 0. 05) . Conclusion] T-tube sheathed U-tube approach for unresectable hilar cholangiocarcinoma is a simple procesure, with decreased morbidity and fewer chances of postoperative biliary tract infection.