Surgical treatment of hilar bile duct carcinoma |
| |
Authors: | Zhiqiang Huang |
| |
Institution: | (1) Department of Hepato-biliary Surgery, General Hospital of PLA, Beijing |
| |
Abstract: | From June, 1986 to June 1989, 24 cases of hilar bile duct carcinoma were explored in the Surgical Department of General Hospital
of PLA, 16/24 cases were resected, a resectability rate of 66%. The increase of resectability rate was due to earlier recognition
of this condition and the extension of surgery, including major resection of liver as well as radical dissection of the hepato-duodenal
ligament and repairative operations on the blood vessels. Among these 16 cases, major hepatic resection was performed in 10
cases, in which, 3 cases of resections of the middle lobe of the liver were done instead of right or extended right lobectomy.
No operative mortality in the 30 days’ postoperative period, but the postoperative morbidity rate was still high and most
of the complications were related to biliary leakage and infection. Three patients died in the follow up period at 6, 14 and
15 months respectively. All of them died from biliary infection. The remaining 13 patients were still alive, the longest being
40 months and the average living time was 16.1 months. Probably, lowering of the operative mortality rate and morbidity rate
are still the most important considerations in the surgical treatment of hilar carcinoma at the present time. Extensive liver
resection especially on the right side, carried a high mortality rate in the deeply jaundiced patients. We considered that
preoperative PTCD was of much less value than that used in lower bile duct obstruction such as tumors of the periampullary
region. Preservation of the superior and posterior portion of the right lobe of the liver may be of advantages as to lowering
postoperative hepatic failure and infection of the right subphrenic space as observed in this series of cases. |
| |
Keywords: | |
本文献已被 SpringerLink 等数据库收录! |
|