肝门部胆管癌的外科治疗  

Surgical treatment for hilar cholangiocarcinoma

作　　者：曹嘉华[1] 李庆怀[1] 王曙光[2] 高静涛[1] 袁克文[1] 李智平[1] 

机构地区：[1]解放军第一医院肝胆外科,甘肃兰州730000 [2]第三军医大学西南医院肝胆外科

出　　处：《西北国防医学杂志》2005年第3期188-190,共3页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨肝门部胆管癌外科治疗策略及其治疗结果。方法:回顾性分析1997-09～2004-10收治的28例肝门部胆管癌的临床资料。结果:Bismuth-CorletteI型10例,II型8例,IIIa型4例,IIIb型3例,IV型3例。手术切除16例(57.1%),其中根治性切除11例(39.3%),姑息性切除5例(17.8%),外引流7例(25.6%),剖腹探查5例(17.9%)。手术切除组、外科引流组及剖腹探查组的平均生存时间分别为20.6、7.3及1.5个月。1例术后10d因肾功能衰竭死亡。结论:治疗应以手术切除为主,根治性切除术可延长患者生存时间。对不能切除的病例应设法减轻黄疸。Objective:To explore the strategy and efficacy of surgical treatment for patients with hilar cholangiocarcinama.Methods: The clinical data of 28 patients with hilar cholangiocarcinamas were reviewed retrospectively. Results: Bismuth-Corlette classification showed type I in 10 patients, type II in 8, type IIIa in 4, type IIIb in 3 and type IV in 3. Tumor resection was performed in 16 patients (57.1%), including radical in 11 patients (39.3%) and palliative resection in 5 patients(17.8%). Seven patients(25.0%) received bile external drainage and five patients(17.9%) underwent exploratory laparotomy. The mean survival time in surgical resection group, external drainagy group and exploratory laparotomy group were 20.6, 7.3 and 1.5 months, respectively. One patient died of renal failure 10 days after surgery. Conclusion: Surgical resection is an effective treatment option for patients with hilar cholangiocarcinamas, and the radical resection is still the primary method for long-term survival of patients and could improve their quility of life. Bile drainage should be performed for patients with unresectable disease.

关 键 词：胆管癌 外科 外引流 

分 类 号：R735.8[医药卫生—肿瘤]