原发性胆管细胞性肝癌42例的外科治疗

目的　评价原发性胆管细胞性肝癌外科诊治的效果。方法　回顾性分析 1996 年 1 月至2001年12月间经手术治疗的42例原发性胆管细胞性肝癌的临床与病理资料。结果　42 例患者以上腹痛、黄疸、上腹包块为主要临床表现,合并胆石症6例;CA19 9检查25例,16例升高;形成单个包块者20例,腹腔淋巴结转移19例。手术切除16例,其中根治性切除13例,同种异体原位肝移植1例。根治性切除生存超过1年者7例,超过3年者4例,超过5年者2例。姑息性切除及肿瘤未切除者无2年生存者。结论　增强对原发性胆管细胞性肝癌的认识,提高早期诊断水平,采用手术切除及肝移植治疗,可提高治疗效果。

Surgical treatment of intrahepatic cholangiocarcinoma, a report of 42 cases

Objective To improve the surgical treatment in patients with intrahepatic cholangiocarcinoma Methods The clinical and pathological features were analyzed in 42 patients with intrahepatic cholangiocarcinoma retrospectively Results The main symptoms were epigastric pain, jaundice and mass Hepatolithiasis was complicated and CA19 9 elevated in 16 out of 25 patients There were 20 cases with single mass formation and 19 with lymph node metastasis Hepatectomy was performed in 16 patients Orthotopic liver transplantation was performed in one patient Seven patients who had received radical resection survived more than 1 year, 3 had survived 4 years and 2 patients are alive for more than 5 years Conclusion Early diagnosis and treatment provide better survival opportunity for patients with intrahepatic cholangiocarcinoma