肝门部胆管癌手术治疗34例临床分析

目的探讨肝门部胆管癌的诊断、手术方式的选择及其疗效。方法回顾性总结分析1994年1月~2004年7月手术治疗的肝门部胆管癌34例的临床资料。结果34例中手术切除22例(64.1%),根治性切除15例(44.1%),姑息性切除7例;内、外引流12例。围手术期死亡9例(26.5%)。出院25例中获得随访21例(84%),平均生存9.6个月。根治性切除10例,平均生存16.1个月,现仍存活6例,分别为5、7、16、24、26、32个月。姑息性切除和引流11例,平均生存5个月,无1年生存者。结论早期诊断和根治性切除是肝门部胆管癌获得根治的唯一途径。选择合理的术式,提高手术技巧和加强围手术期的处理是提高手术疗效的重要措施。

Surgical treatment of hilar cholangiocarcinoma: A clinical analysis of 34 cases

Objective To evaluate the diagnosis and surgical treatment of hilar cholangiocarcinoma(H-CC).Methods Clinical data of 34 patients with H-CC treated surgically in our hospital from Jan.1994 to Jul.2004 were analyzed retrospectively.Results Of the 34 patients,22 underwent resection((64.1 %)),15 radical resection((44.1 %)) and 7 palliative resection.Twelve cases were subjected to internal or external drainage.Nine cases died perioperatively((26.5 %)).Of the 25 cases discharged,21 were fallowed up(84 %).The mean survival time was(9.6) months.In 10 cases subject to radical resection,the mean survival time was(16.1) months and among them,6 survived(with the survival time being 5,7,16,24,26 and 32 months respectively).In 11 cases subject to palliative resection and drainage,the mean survival time was 5 months and no one survived over one year.Conclusion Early diagnosis and radical resection is still the unique choice for the treatment of H-CC.To select operative method properly,experienced operative skills and strengthen the perioperative management are important measures for improving surgical effects.