肝外胆管癌42例诊断及外科治疗

目的探讨肝外胆管癌的诊断和治疗体会。方法回顾性总结42例肝外胆管癌的临床资料、手术方式、手术并发症及生存率。结果术前诊断符合率达64．3％（27／42），CA19—9阳性率为90．5％，根治性手术25例（59．5％），姑息性手术17例（40．5％），根治性切除肿瘤1、2、3年生存率分别为64％（16／25）、36％（9／25）和12％（3／25）；姑息性手术1、2、3年生存率分别为17．6％（3／17）、5．8％（1／17）和0（0／17）。结论早期诊断、正确的评估、合理的术式选择能提高肝外胆管癌的疗效，降低手术并发症及死亡率。

Diagnosis and surgical treatment of forty-two cases of extrahepatic cholangiocarcinoma

Objective To summarize the methods of diagnosis and operation of extrahepatic cholangio- carcinoma. Methods Clinical data of surgical procedures, operative complications and survival rate of 42 cases with extrahepatie cholangiocarcinoma were analyzed retrospectively,and the related archives were reviewed. Re- stilts In this cases, the correct diagnostic rate before operation was 64.3%, the CA19-9 positvie rate was 90.5%. Among them, 25 cases underwent radical resection, 17 cases palliative operation, the cumulative survival rate at the 1-, 2- and 3-year after radical resection were 64%（16/25）, 36%（9/25） and 12%（3/25） respectively. The cumulative survival rate sat the 1-, 2- and 3-year after palliative resection were 17.6%（3/17）, 5.8%（1/17） and 0 respectively. Conclusion Early diagnosis, corrected evaluation and reasonable surgical procedure can improve the curative effect of extrahepatic cholangiocarcinoma and decrease the rate of the operative complication and mortality.