肝外胆管切除在T3 T4胆囊癌根治术临床价值研究  

Extrahepatic bile duct resection in the treatment of T3,T4 gallbladder carcinoma

作　　者：郑亚新[1] 钟明安[1] 胡海[1] 王军臣[2] 张辉[1] 庄志祥[1] 朱江帆[1] 赵中辛[1] 

机构地区：[1]同济大学附属东方医院普外科,上海200120 [2]同济大学附属东方医院病理科,上海200120

出　　处：《中国实用外科杂志》2008年第12期1051-1054,共4页Chinese Journal of Practical Surgery

摘　　要：目的探讨肝外胆管切除在T3、T4胆囊癌根治术或扩大根治术的临床价值。方法将同济大学附属东方医院普外科2004年1月至2006年12月间连续收治的术前或术中确诊的T3、T4胆囊癌随机分为姑息性胆囊切除(n=8)、保留肝外胆管的胆囊癌根治术或扩大根治术(n=9)、切除肝外胆管的胆囊癌根治术或扩大根治术(n=7)三组。观察比较病人临床病理特征、术后并发症发生率及生存情况。结果三组病人年龄、性别分布、并发症发生率差异均无统计学意义;病人术后中位生存期分别为4、6和18个月,切除肝外胆管的胆囊癌根治术或扩大根治术的7例病人术后生存期与前两组病人相比差异具有统计学意义。结论肝外胆管切除是T3、T4胆囊癌获得根治性切除、进而取得较好疗效的重要基础,在胆囊癌外科治疗中具有重要意义。Objective To evaluate the clinical significance of extrahepatic bile duct resection （EBDR）in the treatment of T3,T4 gallbladder carcinoma （GC） Methods Palliative cholecystectomy （n=8）, radical/extended radical resection without EBDR （n=9）, and radical/extended radical resection with EBDR （n=7） were employed performed in 24 patients with T3,T4 GC admitted between January 2004 and December 2006 at Shanghai East Hospital Affiliated to Tong Ji University. Clinicopathologic factors, postoperative complications and survival of the 3 group patients were studiO. Resuils The mean survival of patients after surgery were 4, 6 and 18 months in the 3 groups respectively. There were no significant differences in the proportion of age, sex and postoperative complications among the 3 groups of patients. The 7 patients who underwent radical or extended radical resection with EBDR showed significantly better survival than another two group of patients in whom EBDR was not carried out（P=0.003）. Conclusion EBDR is a necessary surgical＇procedure and is key to the improved survival of patients with T3,T4 GC undergoing radical or extended radical resection.

关 键 词：胆囊肿瘤 肝外肝管 

分 类 号：R6[医药卫生—外科学]