64例肝门部胆管癌患者的诊治分析  

Diagnosis and surgical treatment of hilar cholangiocarcinoma in 64 cases

作　　者：黄越海[1] 

机构地区：[1]重庆市第九人民医院普外科,400700

出　　处：《重庆医学》2010年第21期2936-2937,共2页Chongqing medicine

摘　　要：目的探讨肝门部胆管癌的诊断方法和外科治疗。方法对2002年1月至2009年12月收治的64例肝门部胆管癌的临床资料进行回顾性分析。结果联合应用B超、磁共振胰胆管造影(MRCP)对肝门部胆管确诊率为100%;52例患者获随访,随访率81.3%;手术病死率3.1%;手术切除42例,其中根治性切除22例;内引流16例;外引流6例。根治性切除、姑息性切除、内引流和外引流组术后中位生存时间分别为30.4、15.6、12.9、3.8个月。联合肝叶切除、单纯肿瘤局部切除中位生存时间分别为28.5、16.3个月。结论联合运用影像学检查方法可提高肝门部胆管癌的诊断率。根治性切除及联合肝叶切除是影响肝门部胆管癌患者疗效的主要因素,对无法行根治性切除者以内引流为首选治疗方法 。Objective To investigate the diagnosis and surgical treatment for hilar cholangiocarcinoma.Methods To analyze the clinical data of 64 patients with hilar cholangiocarcinoma retrospectively from Jan.2002 to Dec.2009.Results The diagnosis accuracy rate was 100% by combination use of MRCP and type-B ultrasonic test in hilar cholangiocarcinoma.The operative mortality rate was 3.1%.Of all the cases,42 cases underwent operational resection,including radical resection（22 cases）,internal drainage（16 cases） and external drainage（6 cases）.The mean survival time was：radical resection group,30.4 months;palliative resection group,15.6 months;internal drainage group,12.9 months;external drainage group,3.8 months;hepatectomy group,28.5 months;and simple excision group,16.3 months.Conclusion Combined use of imaging examinations can improve the rate of diagnosis in hilar cholangiocarcinoma.Curative resection and hepatectomy are the main related factors influencing the therapy efficacy and internal drainage is first choice for the patient with hilar cholangiocarcinoma undergoing palliative resection.

关 键 词：肝门部胆管癌 诊断 外科治疗 

分 类 号：R735.8[医药卫生—肿瘤] R730.56[医药卫生—临床医学]