肝胆管结石合并胆管癌的诊断及外科治疗

目的:探讨肝胆管结石合并胆管癌的临床特征和诊治要点。方法:回顾性分析55例肝胆管结石合并胆管癌患者的临床资料，其中23例行根治性手术,32例行姑息手术。结果:病理诊断为胆管腺癌41例，黏液癌14例。51例平均随访3年9个月，根治组平均存活 26(13～45)个月,姑息治疗组平均存活10(5～14)个月。根治组术后 1，2，3年生存率分别为95.7%，54.5%，27.3%,姑息组术后 1年生存率为 37.5％，无2年生存者结论:肝胆管结石反复发作炎症可并发胆管癌，行根治性切除可延长生存期,姑息手术可提高生存质量;提高肝胆管结石合并胆管癌疗效的关键是争取早期根治性治疗肝胆管结石。

The diagnosis and surgical treatment of hepatolithiasis associated with cholangiocarcinoma

Abstract:Objective: To study the clinical characteristics and essential points of diagnosis and treatment of hepatolithiasis associated with cholangiocarcinoma.Methods :The clinical data of 55 cases of hepatolithiasis associated with cholangiocarcinoia were analyzed retrospecively. Among them, radical resection was performed in 23 cases and palliative resetion in 32 cases.〖JP3〗Results:The pathological diagnosis was biliary adeniocarcinoma〖JP〗 in 41 cases, and mucinous carcinoma in 14 cases. Fifty-one patients were followed up for an average 3 years and 9 months, the radical treated group survived an average of 26 (13-45) months, and the palliative conservative treatment group survived an average of 10 (5-14) months. The 1,2,3-year survival rates of radical treatment group was 96.4%, 54.6%, and 24.5% respectively, and for palliative treatment group, the 1-year survival rate of 37.8%, and none survived for 2 years.Conclusions:Hepatobiliary gallstones can repeatedly develop inflammation that can lead to cholangiocarcinoma. Radical resection can prolong survival time, while palliative surgical treatment can improve quality of life. The key to improve the therapeutic outcome of hepatolithcasis with cholangiocarcinoma is to strive for early complete treatment of hepatobiliary gallstone.