肝门胆管癌外科治疗体会：附36例报告

目的:探讨肝门部胆管癌的外科治疗及疗效。方法:对近5年间手术治疗的肝门胆管癌36例的临床资料进行回顾性分析和总结。结果:全组均行手术治疗，发生手术后并发症8例，其中胆瘘5例，腹腔内感染2例，上消化道出血1例，均保守治疗而愈，无手术死亡。在行肿瘤切除术的20例中，15例获随访，存活最短时间为11个月，最长时间3年2个月，中位生存时间1年9个月，1年生存率86.7%(13/15)， 3年生存率13.3%(2/15)。其他各种内外引流术式16例，术后生存5~12个月，平均10个月，术后短期内黄疸减轻，生活质量提高。 结论:肝门部胆管癌应积极手术，不能切除者应力争行各种引流术。

Surgical treatment of hilar cholangiocarcinoma: a report of 36 cases

Objective To discuss the diagnosis and surgical treatment of hilar cholangiocarcinoma(HCC). Methods The clinical data of 36 cases of HCC undergoing surgical treatment in the recent 5 years were analysed and summarized retrospectivly. Results All of the patients in this group underwent operation. Postoperative complications occurred in 8 patients, included biliary fistula in 5, intra abdominal infection in 2 and upper gastrointestinal bleeding in 1; all of the patients recovered with conservative treatment. There was no operative mortality.Of 20 patients who had received tumor resection , 15 were followed up.The median survival time was 1 year and 9 months, and the 1- and 3-year survival rate was 86.7%(13/15) and 13.3% (2/15) respectively. The shortest survival time was 11 months and the longest survuval time was 3 years and 2 month.Survival time was from 5 to 12 months and jaundice was relieved and life quality was improved in 16 and patients who received internal or external drainage. Conclusions HCC should be resected energetically,and,whenever possible,internal or external drainage should be done in unresectable patients .