肝吸虫病合并胆管癌29例报告

目的 探讨肝吸虫病与胆管癌之间的病理机制及其临床诊治经验。方法 回顾性分析肝吸虫病合并胆管癌病人29例。结果男性21例，女性8例，平均年龄62．5岁，高分化腺癌13例(44．8％)，低分化腺癌16例(55．2％)。根治性肿瘤切除术21例(72．4％)，姑息性内引流术5例，剖腹探查活检术3例；生存10年者2例，5年者3例，3年者6例，1年者13例，6个月者4例，3个月者1例。结论 (1)肝吸虫感染、肝吸虫卵的沉积是诱发胆管上皮细胞增生、癌变的重要因素；(2)本病诊断有赖于病理，术中病理活检的广泛应用是提高其诊断符合率的有效措施；(3)治疗仍是以手术为主的综合治疗，能根治性切除则预后佳，不能根治者解决胆道梗阻也可延长生命。

A report of 29 cases of clonorchiasis complicated with cholangiocarcinoma

Objective To explore the pathogenesis of clonorchiasis complicated with cholangiocarcinoma and summarize experience in its treatment. Methods The clinical data of 29 patients with clonorchiasis complicated with cholangiocarcinoma treated in our hospital were retrospectively analyzed. Results Of the 29 patients with an average age of 62.5, 21 were male and 8 female. Thirteen of them (44.8%) were with highly differentiated adenocarcinoma and 16 (55.2%) with lowly differentiated one. Twenty-one patients (72.4%) received radical resection, 5 palliative internal drainage and 3 laparotomy for exploration and biopsy. The survival time was 10 years for 2 patients, 5 years for 3, 3 years for 6, 1 year for 13, 6 months for 4 and 3 months for 1. Conclusions 1) Clonorchiasis infestation is an important reason for cholangiocarcinoma; 2) The diagnosis of this disease depends on pathological examination. Biopsy during the operation is an effective method for increasing the right rate of its diagnosis. 3) Operation is of the first choice for treatment of this disease and the best prognosis depends on whether the tumor is resected or not. Meanwhile, removal of the biliary duct obstruction can prolong the survival time of patients.