肝癌合并胆管癌栓的外科手术治疗疗效分析

目的分析肝癌合并胆管癌栓外科手术治疗效果。方法回顾性分析2006年1月~2014年9月于我院接受手术治疗的100例肝癌合并胆管癌栓患者的临床资料。结果①所有患者均根据肝癌类型选择合适的手术方式,其中接受根治性手术58例,包括肿瘤局部切除术+胆总管切开取栓+T管引流术18例,肝叶切除+胆总管切开取栓术+T管引流术40例;接受姑息性手术42例,其中胆总管切开取栓+T管引流术+患侧肝动脉结扎术28例,胆总管切开取栓+T管引流术14例;手术整体切除率为70.00%。②不同外科手术方式治疗肝癌合并胆管癌栓术后并发症发生率相近;③根治性手术患者术后1年、术后2年总生存率为65.52%、44.83%,均高于姑息性手术的19.05%、7.14%,对比差异有统计学意义(P0.05)。结论对无手术禁忌症的肝癌合并胆管癌栓患者建议尽可能行根治性手术治疗,以提高患者术后生存率。

The effect of surgical treatment of 100 cases with liver cancer complicated with bile duct tumor thrombi

Objective To analyze the effects of surgical treatment of liver cancer complicated with bile duct tumor thrombi.Methods The clinical data of 100 cases with liver cancer complicated with bile duct tumor thrombi admitted in our hospital between January 2006 and September 2014 were retrospectively analyzed.Results ①All patients received appropriate surgery according to the type of liver cancer.Among them,58 patients received radical operation,including 18 cases receiving tumor local excision combined with common bile duct incision embolectomy and T tube drainage and 40 cases receiving hepatic lobectomy combined with common bile duct incision embolectomy and T tube drainage;42 cases received palliative surgery,including 28 cases receiving common bile duct incision embolectomy combined with T tube drainage and hepatic artery ligation of the affected side and 14 cases receiving bile duct incision embolectomy combined with T tube drainage;The overall resection rate was 70.00％.②The incidence rates of postoperative complications were similar in different surgical methods for the treatment of liver cancer complicated with bile duct tumor thrombi;③The 1-year and 2-year total survival rate were 65.52％ and 44.83％ after radical surgery,higher than those of palliative surgery (19.05％,7.14％) (P ＜ 0.05).Conclusion It is recommended that radical surgery be chosen to treat patients with liver cancer complicated with bile duct tumor thrombi and without surgical contraindications to improve postoperative survival rate.