肝门部胆管癌的外科治疗

目的：探讨肝门部胆管癌外科治疗策略及其治疗结果。方法：回顾性分析1997—09～2004-10收治的28例肝门部胆管癌的临床资料。结果：Bismuth—CorletteⅠ型10例，Ⅱ型8例，Ⅲa型4例，Ⅲb型3例，Ⅳ型3例。手术切除16例(57．1％)，其中根治性切除11例(39．3％)，姑息性切除5例(17．8％)，外引流7例(25．6％)，剖腹探查5例(17．9％)。手术切除组、外科引流组及剖腹探查组的平均生存时间分别为20．6、7．3及1．5个月。1例术后10d因肾功能衰竭死亡。结论：治疗应以手术切除为主，根治性切除术可延长患者生存时间。对不能切除的病例应设法减轻黄疸。

Surgical treatment for hilar cholangiocarcinoma

Objective:To explore the strategy and efficacy of surgical treatment for patients with hilar cholangiocarcinama.Methods: The clinical data of 28 patients with hilar cholangiocarcinamas were reviewed retrospectively. Results: Bismuth-Corlette classification showed type I in 10 patients, type II in 8, type IIIa in 4, type IIIb in 3 and type IV in 3. Tumor resection was performed in 16 patients (57.1%), including radical in 11 patients (39.3%) and palliative resection in 5 patients(17.8%). Seven patients(25.0%) received bile external drainage and five patients(17.9%) underwent exploratory laparotomy. The mean survival time in surgical resection group, external drainagy group and exploratory laparotomy group were 20.6, 7.3 and 1.5 months, respectively. One patient died of renal failure 10 days after surgery. Conclusion: Surgical resection is an effective treatment option for patients with hilar cholangiocarcinamas, and the radical resection is still the primary method for long-term survival of patients and could improve their quility of life. Bile drainage should be performed for patients with unresectable disease.