原发性肝细胞癌侵入肝胆管的外科治疗

目的 探讨原发性肝细胞癌侵入肝胆管引起阻塞性黄疸的外科治疗效果．方法 ２３例病人均接受外科手术治疗，单纯胆管癌栓清除＋Ｔ管引流１０例；胆管癌栓清除＋肿瘤切除１０例，其中左半肝切除８例，右半肝切除１例，右肝不规则切除４例。结果 手术死亡３例，存活３￣６个月３例，半年￣１年４例占１７．４％，１年￣２年８例占３４．８％，２年￣３年４例占１７．４％，单纯胆管癌栓清除平均存活时间６．５个月，肝叶切除１７．３

SURGICAL TREATMENT OF PRIMARY HEPATOCELLULAR CARCINOMA INVADING INTO THE HEPATIC BILE DUCT

Objective Discussing the effect of surgical treatment for primary hepatocellular carcinoma(PHCC) which invadesinto the hepatic bile duct and results in obstructive jaundice. Methods 23 patients all received surgical treatment,including carcinoma embolectomy in hepatic bile duct and T-tube drainage in 10 cases,carcinoma embolectomy and tumor dissected in 13 cases (lefthalf hepatectomy in 8 cases,right half hepatectomy in 1 case,irregular right hepatectomy in 4 cases). Results 3 cases died after operation immediately, 3 cases lived from 3 to 6 months, 4 cases from half to one year(17. 4 % ), 8 cases from 1 to 2 years (34. 8 % ), 4cases from 2 to 3 years (17. 4% ),the average living time was 6. 5 months in carcinoma embolectomy only and 17. 3 months in partial hepatectomy. Conclusion The surgical operation is the most effective treatment for releasing symptoms,improving living quality and prolonging living period in these patients. Some patients could meet the radical treatment.