肝门部胆管癌外科治疗162例分析  

Surgical treatment of hilar cholangiocarcinoma:report of 162 cases

作　　者：汪谢丹[1] 郑启昌[1] 胡青刚[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院肝胆外科中心,武汉430022

出　　处：《临床外科杂志》2007年第5期321-323,共3页Journal of Clinical Surgery

摘　　要：目的探讨肝门部胆管癌的诊断方法和外科治疗的疗效。方法回顾性分析1999年9月至2006年9月肝门部胆管癌手术治疗162例临床资料及随访结果。结果应用MR多种显像技术对肝门部胆管癌的定位及定性诊断率100％（86／86）。162例行手术治疗，其中探查术12例，内、外引流术56例，均于术后2～15个月死亡。切除术94例，手术切除率为58％（94／162），行根治性切除62例（17例联合肝动脉重建），中位生存期为29个月，姑息性切除32例，中位生存期为12个月。结论应用MR多种显像技术对肝门部胆管癌的定位及定性诊断率高，能较准确地评价肝门部胆管细胞癌的手术可切除性。根治切除是改善肝门部胆管癌疗效的重要措施；肝动脉重建可以减少术后并发症的发生．Objective To investigate the diagnosis and surgical effectiveness of hilar cholangiocarcinoma. Methods The clinical features,diagnosis,surgical therapy and long- term outcome were retrospectively analyzed in 162 cases of hilar cholangiocarcinoma from September 1999 to September 2006. Results Eighty- six patients with hilar cholangiocarcinoma were diagnosed by imaging of MRI/ MRCP/MRA. The diagnosis accuracy rate was 100 %. All 162 eases were subjected to surgical treatment. Fifty - six cases treated by internal or external drainage had survived for 2 - 15 months. Tumor resection was performed on 94 cases, with a resection rate of 58 % （94/162） including radical resection in 62 eases （median survival time was 29 months）. Thirty - two eases undergoing palliative resection had a median survival period of 12 months. Seventeen cases of hepatic artery invasion were subjected to radical resection in combined with hepatic artery reconstruction. Conclusion MR multi - imaging techniques have high accuracy in the diagnosis of the location and nature of hilar eholangiocarcinoma, and can evaluate accurately the feasibility of resection in patients with hilar cholangiocarcinoma. Radical resection definitely prolongs survival period. The radical resection in combination with hepatic artery reconstruction can increase the resection rate and decrease the postoperative complications.

关 键 词：胆管癌 外科手术 肝动脉重建 

分 类 号：R735.8[医药卫生—肿瘤]