肝门部胆管癌51例的外科治疗

目的探讨肝门部胆管癌的外科治疗方法和效果。方法对经手术和病理检查确定诊断的肝门部胆管癌51例的临床特征、手术方式和随访结果进行回顾性分析。结果肿瘤切除17例,其中根治性切除7例,姑息性切除10例。胆肠吻合15例,单纯探查活检6例,胆道支架置入13例。根治性切除组1,3,5年生存率分别为71%,42%和28%。姑息性切除、胆肠吻合和胆道支架置入组1年生存率分别为20%,0%和31%。结论应力争进行唯一能治愈肝门部胆管癌的根治性切除。如无法根治切除,以胆道支架置入为首选治疗方法。

Surgical Treatment of 51 Cases with Hilar Bile Duct Carcinoma

Objective To evaluate the method of surgical treatment to hilar bile duct carcinoma and its effect.Methods The clinicopathological variables and the follow-up data of 51 patients with hilar bile duct carcinoma were retrospectively analyzed.Results Resection was performed in 17 patients(radical resection in 7,palliative resection in 10),choledochojejunostomy in 15,laparotomy in 6 and stent placement in 13.The 1,3,5-year survival rate of the patients treated with radical resection was 7l%,42% and 28%,respectively.The 1-year survival rate of those treated with palliative resection,choledochojejunostomy and stent placement was 20%,0% and 31%,respectively.Conclusion Radical resection is the first choice for hilar bile duct carcinoma.The biliary stent placement is the primary treatment when radical resection fails.