47例肝门部胆管癌临床治疗分析

目的 探讨肝门部胆管癌治疗方法.方法 回顾性分析2000年1月～2006年1月收治的47例肝门部胆管癌患者的临床资料,其中根治组25例(53.2%),非根治组22例(46.8%).非根治组中姑息性切除2例(4.3%),外引流术16 例(34.0%),行经皮肝癌射频消融术1例(2.1%),探查活检3例(6.4%).结果 根治性手术1、3、5年生存率分别为87.5%、25.0%和12.5%,非根治组均于3年内死亡,其中姑息性切除2例于3年内死亡,外引流术后1年生存率为56.3%,均于术后2年内死亡,单纯探查3例均于术后3月内死亡.根治性切除组1、3、5年生存率显著高于非根治组.结论 根治性切除目前仍是治疗肝门部胆管癌最有效手段,对不能根治切除患者,姑息性切除甚至是引流术也能提高患者生活质量,延长生命.

Analysis on Surgical Management of Hilar Cholangiocarcinoma in 47 Cases

Objective To analyze surgical management of hilar cholangiocarcinoma（HCCC）.Methods The clinical data of 47 cases with hilar cholangiocarcinoma treated with operative therapy from January 2000 to January 2006 were retrospectively analysed.Of these 47 patients,the curative resection group was 25（53.2%）,the non-curative resection group was 22（46.8%）.Of these 22 patients,2 （4.3%） experienced palliative resection, 16（34.0%） underwent drainage operation, 1 （2.1%） performed percutaneous liver cancer radiofrequency ablation,3（6.4%） underwent exploratory biopsy.Result The 1-,3-,and 5-year survival rates for the curative resection group were 87.5%,25.0% and 12.5% respectively.The non-curative resection group died in 3 years.The two patients with palliative resection died in 3 years.And the 1-year survival rate for drainage group was 56.3%,all of the cases died in two years,3 with exploratory biopsy died in three months.There was a significant difference in the cumulative survival rates among the groups treated with different surgical methods.The 1-,3-,and 5-year survival rates were significantly higher in the curative resection group than in the non-curative resection group. Conclusion Curative resection is the most effective method for treatment of hepatic hilar cholangiocarcinoma. However palliative resection and drainage operation may prolong life and improve the quality of living.