不同分型的高位胆管癌手术切除方式的选择

１９９１年１月至１９９５年１２月，本院收治高位胆管癌５２例，手术切除１７例，切除率３２．７％。切除组中２例Ｉ型和１例Ⅱ型肿瘤行单纯局部切除，１４例行联合肝叶切除；其中１例Ⅱ型行尾叶切除，１例Ⅱ型和３例ⅢＡ型行肝中叶切除，８例ⅢＢ型行左半肝切除，１例ⅢＡ型行右半肝切除。镜下治愈性切除率为１５．４％（８／５２）。治愈性切除组平均生存期为２１．１月，姑息性切除组则为７．５个月（Ｐ〈０．０５）。切除组手术

SURGICAL RESECTION FOR HILAR BILE DUCT CANCER BASED ON THE CLASSIFICATION OF TUMOURS

From January 1991 to December 1995, 52 consecutive patients with hilar bile duct cancer were treated in our hospital. Seventeen of them underwent resection with a resectability rate of 32. 7 %. According to the classification of tumours,the different types of resection were adopted as following:local resection for 3 cases,local resection plus caudate lobe or median segment resection in 5 cases,local resection combined right of left hemihepatectomy in 9 cases. Eight of 17 resected patients(15. 4% )had curative resection and 9 did not obtained curability with mean survival of 21. 1 and 7. 5 months respectively. The survival rate of the resected patients was significatly higher than that of the patients who underwent binary decompression,with a 5. 9% operative mortality rate. The results indicate that proper procedures based on the classification of tumours offer the best possibility of prolonged survival with a good quality of life for patients with hilar bile duct cancer.