肝癌合并胆管内癌栓的诊断与治疗效果  

Diagnosis and surgical treatment of primary hepatocellular carcinoma with bile duct thrombi

作　　者：宋晓雪[1] 谢炜[1] 孙安仁[1] 傅翔[1] 

机构地区：[1]重庆市中山医院肝胆外科,重庆400013

出　　处：《第三军医大学学报》2006年第14期1514-1516,共3页Journal of Third Military Medical University

摘　　要：目的探讨原发性肝癌伴胆管癌栓的诊断与外科手术治疗效果。方法回顾性分析原发性肝癌伴胆管癌栓11例，应用B超、CT、ERCP等影像学检查明确诊断，采用肝切除、胆管切开取栓等方法彻底清除胆管癌栓，术后行TA-CE治疗。结果无手术死亡，肝癌切除＋胆管取栓者9例，生存3～38个月，平均18．5个月。TACE＋胆管取栓2例，生存时间分别为6个月和11个月。结论对肝癌侵犯胆管形成癌栓者及时诊断，尽早切除肿瘤、清除癌栓是一种积极有效的治疗方法。Objective To evaluate the effect of surgical treatment for primary hepatocellular carcinoma （HCC） with bile duct thrombi （BDT）. Methods Eleven cases were diagnosed as HCC with BDT by B ultrasound, CT, MRCP or ERCP. Hepatectomy and choledochotomy were performed, resecting the primary tumor and cleaning the BDT completely, followed with TACE. Results No patients died during operation. The survival time of 9 patients who received hepatectomy and BDT clearance ranged from 3 to 38 （ average 18.5 ） months, and that of the other two patients received TACE and BDT clearance survived 6 and 11 months respectively. Conclusion Accurate diagnosis and radical hepateetomy with complete BDT clearance are effective treatment for HCC with BDT.

关 键 词：原发性肝癌 胆管癌栓 肝切除术 

分 类 号：R657.43[医药卫生—外科学] R730.56[医药卫生—临床医学]