联合右三叶切除并门静脉重建治疗肝门胆管癌1例报道

目的 报道1例联合右三叶切除及门静脉重建治疗肝门胆管癌，综述国内、外发展现状。方法 肝门胆管癌1例，术前总胆红素为480．2umol／L，联合切除右三叶及全尾状叶，并作门静脉部分切除、重建。检索国内、外文献。结果 术后病理示中分化胆管细胞癌，淋巴结转移（3／3）。病人出现中量腹水但恢复顺利。10月后肿瘤复发，共存活13个月。本例是文献报道行该术式血清胆红素水平最高者。国内此类手术开展很少。国外经验认为该术式可提高切除率与治愈率。结论 部分肝门胆管癌病人可直接耐受联合右三叶切除及门静脉重建。

COMBINED RIGHT TRISEGMENTECTOMY PLUS PORTAL VEIN RECONSTRUCTION FOR HILAR CHOLANGIOCARCINOMA-1 CASE REPORT AND LITERATURE REVIEW

Objective To present 1 right trisegmentectomy plus portal vein reconstruction for hilar cholangiocarcinoma(HCC) and to review literatures.Methods Right trisegmentectomy plus partial portal vein resection and reconstruction was performed on 1 HCC patient(total bilirubin 480.2 umol/L).literatures were reviewed.Results Pathological results showed moderate cholangiocarcinoma and positive lymph nodes(3/3).Except ascites,his recovery was uneventful.Tumor recurrence happened 10ms latter and he survived 13 ms.To our knowledge,it was the highest serum bilirubin level,which being seldom performed indoors but accepted overseas.Conclusions Right trisegmentectomy plus portal vein resection and reconstruction can be performed on selected HCC patients directly.