肝门部胆管癌治疗方式的选择

目的 :通过分析 36例肝门部胆管癌治疗方式与疗效的关系 ,为肝门部胆管癌的治疗选择合理的方法和改善其疗效提供临床依据。方法 :对 36例患者按不同的治疗方式分为根治性切除、姑息性切除、胆肠内引流、金属支架内引流和外引流 5组 ,分析各种治疗方式与病变分型、生存时间和并发症的关系。结果 :平均生存时间 ,根治性切除组 3 .3年 ;姑息性切除组 2 0月 ;胆肠内引流组 13月 ;金属支架内引流组 12月 ;外引流组 6 .3月。总并发症2 2 .2 %。手术死亡率 0 %。结论 :肝门部胆管癌的治疗应首选根治性切除 ,选择性的肝段切除是更合适的 ,姑息性切除的疗效优于各种内外引流术 ,胆肠吻合内引流术和金属支架内引流疗效相似。

The Selection of Methods for the Treatment of Hilar Cholangiocarcinoma

Objective: To provide experience of selecting therapeutic methods for the treatment of hilar cholangiocarcinoma and improve the therapeutic effects. Methods: According to different therapeutic methods,36 cases were put in 5 groups of radical resection, local resection, cholangiojejuno Roux Y anastomosis inner drainage, metal stent insert and external drainage. The relations between different therapeutic procedures and types, survival time and complications were analysed. Results: The survival time of radical resection group arerages 3.3 years; local resection group 20 months; cholangiojejuno anastomosis group 13 months; metal stent insert group 12 months; and external drainage group 6.3 months. Total complications were 22.2 percent. Operation mortality was 0 percent. Conclusion:Radical resection should be selected first for the treatment of hilar cholangiocarcinoma. Selected hepatic segment resection is more suitable. The result of local resection is better than that of all kinds of inner or external drainage methods. The results of cholangiojejuno anastomosis and metal stent inner drainage are similar.