肝门部胆管癌126例临床分析

目的:分析肝门部胆管癌的诊断及手术治疗方法。方法:回顾分析2002-03~2007-03肝门部胆管癌手术治疗126例临床资料及随访结果。结果:按照Bismuth-Corlette分型法,Ⅰ型12例,Ⅱ型25例,Ⅲa型26例,Ⅲb型33例,Ⅳ型30例。B超、CT和磁共振胆胰管成像(MRCP)的确诊率分别为83.8%、92.1%及96.7%。126例中,根治性切除33例,姑息性切除22例,胆道引流46例,未手术25例。总手术率80.2%(101/126),根治性切除率32.7%(33/101)。根治性切除患者的1、3、5年生存率分别为81.8%、42.4%、24.2%,姑息性切除组分别为50.0%、18.2%、9.1%,单纯引流组分别为4.3%、0、0,未手术组分别为4.0%、0、0。根治性切除组和姑息性切除组生存率差异有统计学意义(P<0.05)。结论:提高手术切除率是改善肝门部胆管癌预后的唯一有效方法,肝十二指肠韧带骨骼化、肝部分切除可提高根治性切除率。

Surgical treatment of hilar cholangiocarcinoma:areport of 126 cases

Objective:To analyze the diagnosis and method of surgical therapy of hilar cholangiocarcinoma.Methods: The clinical features,diagnosis,surgical therapy and long-term outcome were retrospectively analyzed in 126 cases of hilar cholangiocarcinoma from March 2002 to March 2007.Results:According to the Bismuth-Corlette staging system,12 cases were type Ⅰ,25 type Ⅱ,26 type Ⅲa,33 type Ⅲb,and 30 type Ⅳ.The rate of making correct diagnosis by ultrasound,CT and MRCP was 83.8%,92.1% and 96.7%,respectively.Of these 12...