肝门部胆管癌的外科治疗(附65例报告)  

Surgical treatment for hilar cholangiocarcinoma

作　　者：陈永标[1] 张绍庚[1] 江艺[1] 吕立志[1] 胡还章[1] 林华[1] 

机构地区：[1]南京军区福州总医院肝胆外科,福建福州350025

出　　处：《中国现代医学杂志》2006年第21期3327-3329,共3页China Journal of Modern Medicine

摘　　要：目的探讨肝门部胆管癌不同外科治疗方法对患者预后的影响。方法对该院1993年1月￣2004年12月经手术和病理确诊的65例肝门部胆管癌的临床资料进行回顾性分析总结。结果65例患者中,男38例,女27例,男女之比1.4∶1。手术切除26例,切除率为40.0%(26/65)。其中根治性切除18例,姑息切除8例,内或外引流术34例,探查性手术5例。根治性切除1、2、3年生存率分别为77.0%、46.2%、15.4%;姑息性切除者1、2年生存率分别为43.0%、14.3%;非切除引流者1年生存率为11.0%;探查性手术者生存期均小于3个月。肝门部胆管癌根治性切除术后平均生存时间较姑息性切除术组和非切除引流术组明显延长(P值分别为0.011、0.000)。结论根治性切除术是提高肝门部胆管癌存活率的关健;对不能根治者行姑息性切除或引流术可延长生存时间和提高生活质量。[Objective] To investigate the correlation between prognosis and surgical management in patients with hilar cholangiocareinoma. [Methods] Retrospective study was used to analyze the clinical data after operation of 65 patiens from January 1993 to December 2004. [Results] Of the patients, There were 38 males and 27 females, with M：F=1.4：1. 26 underwent resection （radical resetion, 18; palliative resection, 8）, 34 nonresectional internal or external drainage and 5 laparotomy. In the radical resection group, the 1, 2, 3-year survival rates were 77.00%, 46.15%, 15.38%. The 1, 2-year survival rate were 43.0%, 14.3% in the palliative resection group. Whereas, the 1-year survival rate of the nonresection drainage group was 11%. The average survival period of radical resection group was significandy longer than that of the palliative resection group and of the nonresection drainage group （P=0.011, 0.000 respectively）. [Conclusion] Radical resection is crucial to enhance survival rate in hilar cholangiocareinoma. Palliative resection and nonresectional drainage could prolong the life or improve the quality of life among the patients with hilar cholangiocareinoma.

关 键 词：肝门部胆管癌 外科手术 预后 

分 类 号：R735.8[医药卫生—肿瘤]