肝门胆管癌手术切除26例疗效分析  

Excision of Proximal Bile Duct Cancer-An Analysis of 26 Cases

作　　者：魏洪臣[1] 牛跃平[1] 周志强[1] 

机构地区：[1]河南医科大学第二附属医院普外科

出　　处：《中国肿瘤临床》1998年第2期128-130,共3页Chinese Journal of Clinical Oncology

摘　　要：肝门胆管癌，７０年代以前大多数病例难以切除，视为手术禁区。随着医学科学技术的快速发展，早期病例诊断率明显提高，手术切除率也提高至６０％左右。从１９８８～１９９６年共施行肝门胆管癌手术切除２６例取得较好效果。Ⅰ型（肝总管癌）１０例，Ⅱ型（肝管汇合部癌）７例，Ⅲ型（左肝管及肝总管癌）４例，Ⅳ型（右肝管及肝总管癌）３例，Ⅴ型（左、右肝管和肝总管癌）２例。手术方法为单纯肝门胆管癌切除，肝门胆管及半肝切除，肝中央部切除，扩大半肝切除后与空肠行Ｒｏｕｘ－ｅｎ－Ｙ吻合术。作者对手术切除方法，禁忌证，治疗效果等进行了详细讨论。所有病例均行胆管或肝断面与空肠吻合术，术后并发症少，再次手术少，疗效满意。From 1988 to 1996,26 cases of proximal bile duct cancers were treated　surgically with fair result. According to the classification of Bismuth and　Corlette there were 10 type I (common hepatic duct cancer) ; 7 type II (cancer　at the confluence of hepatic ducts);4 type III(left hepatic duct and common hepatic duct cancer);3 type IV(right hepatic duct and common hepatic duct　cancer).The surgery performed included simple excision of cancer at porta　hepatis,excision of portal bile duct and hemihepatectomy,central part　hepatectomy,extensive hemihepatectomy with Rouxeny anastomosis to jejunum.The　operative procedures,contraindications of surgery and therapeutic effects were discussed in detail. It is considered that hemihepatectomy with Rouxeny choledochoenterostomy is of choice with lesser complication,fewer chances of reoperation and satisfactory result.

关 键 词：根治性切除 吻合术 肝肿瘤 外科手术 

分 类 号：R735.7[医药卫生—肿瘤] R730.56[医药卫生—临床医学]