肝门部胆管癌的外科治疗43例疗效分析

目的探讨肝门部胆管癌外科治疗术式的选择和效果.方法对1992年7月至2002年7月手术治疗43例肝门部胆管癌的临床资料总结,包括临床表现、手术方式、临床分型、治疗效果.结果无痛性梗阻性黄疸者占53.5%.根治性切除18例,姑息性切除6例,单纯引流减黄手术15例,肿瘤活检4例.肿瘤切除者1、3年生存率分别为82.4%、23.5%,单纯引流者1、3年生存率为58.3%、0,肿瘤切除明显优于单纯引流(P＜0.05).结论手术治疗是提高肝门部胆管癌远期生存率及改善生活质量的关键,简化术前检查,力求早期手术,争取肿瘤切除.

Clinical experience with surgical treatment for hilar cholangiocarcinoma:a report of 43 cases

Objective To investigate the selection and effect of surgical treatment for hilar cholangiocarcinoma.Methods 43 patients with hilar cholangiocarcinoma underwent surgical treatment from Jury 1992 to Jury 2002.The results were analyzed retrospectively,including clinic character,operation pattern,effect of treatment.Results 53.5% of patients were characteristic with non-pain jaundice.18 cases underwent radical resection and 6 cases underwent palliative resection.15 cases were subjected to nonresectional internal or external drainage and 4 patients underwent biopsy only.In the resection group,the 1,3-year survival rates were 82.4%,23.5%.In the drainage group,the 1-year survival rates were 58.3%and None survived for over 3 years.Conclusions Surgical treatment is a major procedure for the management of hilar cholangiocarcinoma.Early operation was recommended after necessary and simplified examination,and tumor resection was associated with favorable outcome.