肝胰十二指肠切除术治疗肝门部胆管癌：附11例  

Surgical treatment of hilar cholangiocarcinoma by hepatopancreatoduodenostomy

作　　者：时开网[1] 席鹏程[1] 杨坤兴[1] 倪绍忠[1] 

机构地区：[1]南京医科大学附属南京第一医院普外科,210006

出　　处：《中华肝胆外科杂志》2010年第1期13-14,共2页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的总结肝胰十二指肠切除术（HPD）治疗肝门部胆管癌的经验。方法回顾性分析2000年6月至2008年1月11例HPD治疗肝门部胆管癌的临床资料。结果全组11例肝门部胆管癌按Bismush-corlitte分型，Ⅲ型8例，Ⅳ型3例。肝方叶切除＋胰十二指肠切除术2例，肝尾叶切除＋胰十二指肠切除术5例。右半肝＋尾状叶＋门静脉部分切除重建＋胰十二指肠切除术1例，左半肝＋胰十二指肠切除术3例，无死亡。胆漏3例，胰漏1例，肺部感染2例，肝功能衰竭1例，随访8例，最长者63个月。结论对肝门部胆管癌累及胰十二指肠区域者，HPD可提高其生存质量，是安全可行的。Objective To summarize the experience in performance of hepatopancreatoduodenostomy for hilar cholangiocarcinoma. Methods The clinical data of 11 cases of hilar cholangiocarcino ma receiving hepatopancreatoduodenostomy in our hospital from June 2000 to January 2008 were retrospectively analyzed. Results For Bismush-corlitte classification, 8 cases were grade Ⅲ the others Ⅳ. Quadrate lobectomy plus pancreaticoduodenectomy was performed in 2 patients, caudate lobectomy plus pancreaticoduodenostomy in 5, hepatectomy in right half plus caudate lobectomy, pancreaticoduodenostomy and PV lateral wall partial resection and reconstruction in 1, hepatectomy in left half and pancreaticoduodenostomy in 3. There were no death. Three patients had the complication of biliary fistula, 1 pancreatic fistula, 2 pulmonary infection and 1 liver functional failure. The follow-up in 8 patients showed that the longest survival was 63 months. Conclusion HPD is safe and feasible for treatment of hilar eholan- giocarcinoma invading the region of pancreaticoduodensum and it can promote the life quality of patients.

关 键 词：胆管肿瘤 肝胰十二指肠切除术 

分 类 号：R735.8[医药卫生—肿瘤] R587.2[医药卫生—临床医学]