肝外胆管癌(附46例临床分析)  

Extrahepatic Bile Duct Carcinoma A Report of 46 Cases

作　　者：白振杰[1] 冀兵[1] 

机构地区：[1]河南省人民医院肝胆外科,郑州450003

出　　处：《肝胆外科杂志》1997年第2期103-105,共3页Journal of Hepatobiliary Surgery

摘　　要：本文报告46例胆管癌，其中上段胆管癌28例，中段4例，下段6例，广泛胆管癌6例。根治性切除7例，切除率16％。病理结果，胆管腺癌36例，占81％。胆管癌诊断上除病史体征外，主要依靠B超，PTC和CT检查。有关早期诊断，作者认为应重视以下几方面：①临床外科医生对本病要有足够的认识；②遇到进行性黄疽病人及时首选B超检查；③对B超不能解释的肝内外胆管扩张的病例，应及时采用PTC和ERCP直接胆道造影检查；④手术中重视胆道镜的应用，如有可疑的病变，及时取材活检。胆管癌的治疗仍以手术切除为主。应尽早手术，力争根治。对于不能根治的病例，应设法解决黄疸延长生命。This paper reports 46 patients with extrahepatic bile duct carcinoma. The carcinoma lacted in the upper section of extrahepatic bile duct in 28 patients,in the middle portion in 4 patients,in the under portion 6 patients. The widespread bile duct carcinoma was found in 6 patients, The radical section was performaed in 7 patients (resection rate was 16%). The pathological examination showed that the adenocarcinoma was found in 36 patients (81%).Except for medical history and physical examination,the diagnosis of bile duct carcinoma maimly depends on B-us PTC and CT. The authers believe that the key points of early diagnosis was: 1. Clinial Surgeons must have enough recognition for this disease; 2. B-us must be choiced first when patient has progressive jaundice medical advice;3. For the patients with intrahepatic or extrahepatic bile duct distention, the jaundice can't be explained by B-us,the direct cholangiography such as PTC or ERCP must be used in time;4. During operation,the use of cholangioscope should be performed,when the suspicious neoplasm changes were found,the biopsy should be performed.The treatment of bile duct carcinoma mainly is surgical operation. The operation should be done as soon as early,and tried hard to do radical operation. For those patients that the radical operation can't be performaed,the operation relieved the jaundice should be strived to per form so as to prolongate the life.

关 键 词：胆管肿瘤 临床分析 

分 类 号：R735.8[医药卫生—肿瘤]