Bismuth Ⅳ型肝门部胆管癌的外科治疗

目的 探讨Bismuth Ⅳ型肝门部胆管癌的外科手术治疗效果.方法 10例病人(男2例、女8例;年龄35～74岁)术前诊断为BismuthⅣ型肝门部胆管癌.全组病人均接受手术治疗.结果 全组病人无围手术期死亡.术后主要并发症包括:胆肠吻合口瘘3例,胆瘘1例,右侧膈下脓肿形成1例,腹腔出血1例.6例病人术后分别随访12、16、22、26、28和30个月,病情稳定.其余4例病人分别于手术后9、10、11和15个月死于肿瘤转移播散.术后1年和2年的生存率分别为70%和60%.结论 BismuthⅣ型肝门部胆管癌应采取积极的外科手术治疗,选择恰当的手术治疗方式可以明显延长病人生存时间.

Surgical treatment of Bismuth type Ⅳ hilar cholangiocarcinoma

Objective To investigate the efficacy of surgical treatment for Bismuth type IV hilarcholangiocarcinoma. Methods Ten patients (2 males and 8 females with an age of 35～74 years) were diagnosed to suffer from Bismuth type IV hilar cholangiocareinoma before operation. Resection of the tumor was carried out in all the patients. Results No death occurred in the period of 30 days after op-eration. The main postoperative complications included anastomosis leakage in 3 cases, bile leakage in 1, right subphrenic abscess in 1 and intraabdominal bleeding in 1. Six patients are alive after operation and have been followed up for 12 to 30 months. The other 4 patients died in 9 to 15 months after oper-ation. The 1-year and 2-year survival rates were 70% and 60%, respectively. Conclusion Aggressive surgical treatment can markedly prolong the survival time of the patients suffering from Bismuth type Ⅳ hilar eholangiocarcinoma.