肝门部胆管癌手术切除10例报告

目的：总结肝门部胆管癌的手术治疗经验。方法：回顾性分析1999年6月至2002年6月手术切除的肝门部胆管癌10例的临床资料。结果：手术切除数占同期总手术倒数47.6%(10/21),根治性切除率为28．6％（6／21）,无手术死亡。根治性切除患者中有2例分别于术后16个月和21个月死于肿瘤复发,有4例仍存活,平均生存18个月。姑息性切除患者有1例存活,其余3例死亡,平均生存10．5个月。结论：肝门部胆管癌应尽可能行切除手术,肝十二指肠韧带骨骼化和联合肝切除是根治术的基本要求和延长生存期的重要措施。用PMOD进行刮吸解剖,对手术成功有帮助。

Surgical Treatment of Hilar Cholangiocarcinoma

Objective: To evaluate the surgical therapy experience of hilar cholangiocarcinoma.Methods:10 cases of hilar cholangiocarcinoma were surgically treated in this hospital from Jun. 1999 to Jun. 2002.Results:The tumor resection rate was 47.6%(10/21)in this series.Radical resection rate was 28.6%(6/21).There was no operative death,although 2 patients treated with radical resection died of tumor recidivisming in 16 months and 21 months after operation,respectively.The average survival time was 18 months with 4 patients still living. However,among the 4 patients treated with palliative resection,the average survival time was 10.5 months with 1 patient still living and 3 patients died.Conclusion:Operative resection should be attempted if feasible for hilar cholangiocarcinoma.The ligament of liver-duodenum skeletonzation and unite hepatectomy are basic require of radical resection and important measure of prolong survival time.It is helpful to use PMOD (Peng's multifunctional dissector) by means of " curettage and aspiration technique,CAT.