34例肝门部胆管癌的诊断和治疗

目的:探讨肝门部胆管癌合理选择治疗方式,方法:对34例患者按不同的治疗方式分为根治性切除, 姑息性切除,胆肠内引流,金属支架内引流和外引流5组,分析各种治疗方式与病变分型,生存时间和并发症的关系.结果:生存时间,根治性切除组3.3年,姑息性切除组平均20个月,胆肠内引流组平均13个月,金属支架内引流组平均12个月;外引流组6.3个月;总并发症23.5%,手术死亡率0.结论:肝门部胆管癌的治疗应首选根治性切除,选择性和肝段切除是更适合的,姑息性切除的疗效优于各种内外引流术,胆肠吻合内引流术和金属支架内引流疗效相似.

Diagnosis and treatment of 34 cases with hilar cholangiocarcinoma

Objective The incidence of hilar cholangiocarcinoma tends upwards. Long term results of the treatment remain very poor. A retrospective summary for clinical record of diagnosis and treatment in 34 patients with hilar cholangiocarcinoma was undertaken. The purpose of the paper is to search select the rational therapeutic methods.Methods According to therapeutic methods, 34 were was classified into 5 groups (radical resection,local resection, cholangiojejuno Roux Y anastomosis inner drainage , metal stent inner and external drainage).The relationships among different therapeutic procedures and types, survival time, complications were analyzed.Results The average survival time was 3.3 years in radical resection group;20 months in local resection group;13 months in cholngiojejuno anastomosis group;12 months in metal stent inner drainage group;6.3 months in external drainage group.Total rate of complications was 23.5 percent.Operative mortality was 0 per cent.Conclusious The first choice of treatments for hilar cholangiocarcinoma is radical resection. Selected heptic segment resection is more suitable. Result of local resection is better than all kind of inner or external drain ways. The results of cholangiojejuno anastomosis and metal stent inner drainage are similar.