肝门胆管癌44例治疗分析

目的 探讨肝门胆管癌的治疗.方法 回顾性分析我院2000～2005年收治的44例肝门胆管癌病人的临床资料.结果 本组手术治疗40例,手术切除率为42.5%(17/40),根治性切除8例(20%),姑息性切除9例(22.5%),单纯内引流、外引流各10例,3例仅行剖腹探查.4例病人合并肝叶切除,术后1例出现肝功能衰竭.未行肝叶切除病人无1例发生肝功能衰竭.结论 Bismuth-Corlette分型可指导手术方式选择,但能否切除取决于病期.黄疸较深且拟行较大肝叶切除术时应行术前减黄,可减少术后肝功能衰竭的发生.

AN ANALYSIS OF THE TREATMENT OF 44 CASES OF HILAR CHOLANGIOCARCINOMA

Objectve To discuss the treatment of hilar cholangiocarcinoma. Methods. The clinical data of 44 patients with hilar cholangiocarcinoma in our hospital from 2000 to 2005 were retrospectively analyzed. Results 40 patients were treated with operation, including 8 cases of radical excision, 9 cases of paliative excision, 10 cases of internal drainage, 10 cases of external drainage and 3 cases of laparotomy, resulting in a resectability of 42. 5 %. Four patients were operated on resective surgery combined with hepatectomy, one of which developed liver, failure, while none of the patients without hepatectomy developed liver failure, Conclusions The Bismuth-Corlette classification is a guide to the extent of surgery required, but the respectability depends on the stage. Those patients who were jaundiced and required hepatectomy should be drained preoperatively to reduce liver failure.