肝内胆管结石合并胆管癌38例临床分析  

Diagnosis and treatment of 38 cases of intrahepatic lithiasis combined with cholangiocarcinoma

作　　者：程玉[1] 罗云藩[1] 廖锦岐[1] 邓予[1] 黄华容[1] 

机构地区：[1]广东省惠州市中心人民医院肝胆外科,516001

出　　处：《临床外科杂志》2012年第7期473-475,共3页Journal of Clinical Surgery

摘　　要：目的 探讨肝内胆管结石合并胆管癌的诊断、治疗以及微创外科时代肝部分切除在肝内胆管结石治疗中的意义.方法 分析我院收治的38例胆管结石并胆管癌患者的临床资料.结果 我院1998年3月至2011年12月间,胆管癌的患者为225例,同期肝胆管结石患者2333例.手术切除组21例,平均生存时间为32.9个月,1、2、3年生存率分别为85.71%、71.43%、52.38%;介入治疗组13例,平均生存时间为6.85个月,0.5、1、2年生存率分别为46.15%、7.69%、0.结论 肝内胆管结石长期的炎症、反复的感染、胆汁淤积等因素是肝内胆管癌发生的重要因素.肝部分切除不仅能够去除结石、预防结石复发,对于预防胆管癌变亦具有重要的意义.Objective To analyze the diagnosis and treatment of primary intrahepatic lithiasis combined with cholangiocarcinoma and the significance of hepatectomy in era of minimally invasive surgery. Methods Data of 38 cases of intrahepatic lithiasis combined with cholangiocarcinoma from March 1998 to December 2011 in our hospital were retrospectively studied. Results There were 225 cases of cholan- giocarcinoma and 2333 cases of intrahepatic lithiasis between March 1998 to December 2011. The average survival time of radical surgery group was 32.9 months, and the cumulative survival rates at the 1 st, 2nd and 3rd year were 85.71% ,71.43% ,52.38% respectively. The average survival time of intervention group was 6.85 ,and the cumulative survival rates at the half, lnd and 2rd year were 46.15% ,7.69%, 0% respectively. Conclusion Intrahepatic chalangiocarcinoma could be a consequence of long term chro- nic inflammation,infection and bile stasis caused by primary intrahepatic lithiasis. Hepatectomy can not only remove intrahepatic stones and prevent recurrence of hepatolithiasis, but also prevent intrahepatic cholangiocarcinoma. Hepatectomy still is irreplaceable in era of minimally invasive xurgery.

关 键 词：肝内胆管结石 胆管癌 肝切除 

分 类 号：R735.1[医药卫生—肿瘤]