肝胆管结石合并肝内胆管癌14例临床分析

目的探讨对肝胆管结石合并肝内胆管癌临床特点和诊治方法。方法对我科在1995年1月至2004年12月收治的14例肝胆管结石合并肝内胆管癌的临床资料进行回顾性分析。结果肝内胆管癌术前诊断率为42.9%(6/14)。14例均经手术治疗,4例行根治性切除,根治性切除率28.6为%(4/14),痊愈出院。术后死亡1例,为重度感染致肝功能衰竭,1例为病情加重而自动出院,其余10例好转出院。术后平均生存33个月,姑息性手术10例,术后平均生存3个月。结论对50岁以上,病史较长,反复胆管炎发作,短期内消瘦,进行性黄疸加重的肝胆管结石病人,应高度警惕并发胆管癌可能。提高疗效的关键是早期诊断,早期治疗,争取根治性切除。

Clinical analysis of 14 cases with hepatolithiasis associated with intrahepatic cholangiocarcinoma

Objective To investigate the clinical features of hepatolithiasis associated with intrahepatic cholangiocarcinoma and it's diagnostic and therapeutic methods. Methods From January 1995 to December 2004,14 cases with hepatolithiasis associated with intrahepatic cholangiocarcinoma were analyzed retrospectivcly. Results 14 cases underwent operative treatment, 1 case diedom 10 th day after operative, the patient died from liverfailure Aother case was give up treatmeut because of exacerbation of patient's status, Radical resection rate was 28.6%(4/14), and postoperativc averagc survival time (PAST) was 33 months. Palliativc operations were 10 cases and PAST was 3 months.Conclusion when the patients have over 50 years old,longer history of hepatolithiasis accompanied by recurrent cholangitis, progressivc exacerbated jaundice and within shortterm magersucht, the intrahepatic cholangiocarcinoma should be considered.For improving the curative effect, it is the keys to early diagnosis and treatment and obtaining radical resection.