肝切除在肝门部胆管癌手术中的应用和选择

目的 观察肝叶切除在肝门部肝管癌根治术中的疗效并探讨根治性切除术的范围。方法 自１９９５年２月至１９９７年３月手术切除肝门部胆管癌９例，姑息性切除２例，根治性切除７例，８例行各种类型肝切除。结果 姑息性切除１例术后１２个月发生肝内转移，存活１６个月；另１例仍存活，术后２７个月出现阻塞性黄疸。根治性切除１例术后１１ｄ死于肺部感染，其余存活至今。结论 肝切除术肝门部胆管癌根治性切除术中手重要组成部分，

Hepatectomy for thetreatment of patients with hilar cholangiocarcinoma

Objective To evaluate the effect of curative resection for the patients with hilar cholangiocarcinoma and to explore the limits of curative resection. Methods From Feb. 1995 to Mar. 1997 nine patients with hilar cholangiocarcinoma were treated surgically. Palliative resection in was performed 2 cases, curative resection in 7 cases. Among them hepatectomy was carried out in 8 cases. Results Intrahepatic metastasis occured in one patient treated with palliative resection in 12th month postoperation, the other one who is still alive has relapsed into obstructive jaundice in 27th month postoperation. All patients undergoing curative resection survive up to the end of this follow up,except one who died of pneumonia day 11 postoperation.Conclusions Hepatectomy is an important procedure of curative resection for hilar cholangiocarcinoma.The limits of resection should be decided according to the tumor classification, extent involved and intraoperative biopsy. It is not an absolute contraindication of curative resection for those patients with tumor involving portal vein.