进行性肝动脉侵犯:影响肝门部胆管癌预后的重要因素  

PROGRESSIVE INVASION OF HEPATIC ARTERY:AN IMPORTANT FACTOR IMPACTING ON POSTOPERATIVE PROGNOSIS OF HILAR CHOLANGIOCARCINOMA

作　　者：梅铭惠[1] 冯健麟[1] 陈谦[1] 徐静[1] 杨景红[1] 邓伟 

机构地区：[1]桂林医学院附院,桂林541001

出　　处：《肝胆外科杂志》1999年第6期438-441,共4页Journal of Hepatobiliary Surgery

摘　　要：目的　了解肝门部胆管癌 ( Hilar cholangiocarcinoma HC)侵犯周围血管神经的生物学特性和术后经导管肝动脉灌注( TAI)对 HC的辅助疗效。　方法　外科治疗 2 6例 HC,对行病变胆管切除的 8例作术后定期 TAI,同时观察肝动脉损害及 TAI的效果。结果　 2 0例行病变胆管切除 ,切除率 77%。选择性肝动脉造影的结果显示 ,8例 HC均存在不同程度的肝动脉侵犯 ,常规的术前检查方法无法确定这种损害。其临床特征在术前即可存在 ,术后呈进行性加重 ,成为 HC病情迅速恶化和患者死亡的重要原因之一。术后定期的 TAI治疗可部分缓解 HC进行性肝动脉破坏 ,改善肝脏的供血。　结论　为进一步明确 HC的病变程度和合理选择术式 ,作者认为术前除 PTC,B超 ,CT和 ERCP等检查外 ,应尽可能做选择性肝动脉造影。Objective To investigate the biological characteristics of invading periduct artery by hilar cholangiocarcinoma (HC) and the effectiveness of postoperative transcatheter arterial infusion(TA) for HC.Method 26 patients with HC underwent surgical treatment and 8 cases were received postoperative TAI regularly.The hepatic arterial invasion and the results of chemotherapy for HC were observed.Results HC local resection and resection with hepatectomies were performed in 20 cases,the resection rate was 77%.Selective angiography in 8 patients showed that the hepatic arterial invasion by HC was found in all cases ,which was not be found preoperatively.This pathological lesion may exist in the early stage of the disease and deteriorate postoperatively,which may be one causes of rapid aggravation and the death of HC patients.With the treatment of TAI,the progressive arterial invasion of HC can be partially relieved in some patients.Conclusion According to this study,it is suggested that to understand the extent of HC more precisely,choose more pertinent surgical approaches for HC preoperatively and selective hepatic angiography should be undertaken except the examinations of PTC,CT,Bus and ERCP and so on.In addition,the postoperative TAI may further improve the survival of the patients.

关 键 词：肝门部 胆管癌 预后 治疗 

分 类 号：R735.8[医药卫生—肿瘤]