肝门胆管癌外科治疗疗效评价  

The Evaluation of Surgical Treatments for Hilar Cholangiocarcinoma

作　　者：宗帝[1,2] 曾勇[1] 

机构地区：[1]四川大学华西医院肝胆胰外科,成都610041 [2]四川省医学科学院.四川省人民医院整形外科

出　　处：《华西医学》2013年第9期1387-1390,共4页West China Medical Journal

摘　　要：目的对肝门胆管癌外科治疗疗效进行评价。方法回顾分析2007年3月-2012年3月收治的156例肝门胆管癌患者的临床资料。按手术方式将患者分为手术切除组(n=45)、胆道引流组(n=78)和姑息治疗组(n=33),并对住院期间并发症发生率、病死率及生存时间等进行分析。结果 156例患者根治性切率为23.1%不同治疗方式住院期间病死率差异无统计学意义(P<0.05);手术治疗组与姑息治疗组并发症发生率差异有统计学意义(P<0.05)。手术切除组、胆道引流组、姑息治疗组的1、3、5年累积生存率分别为64.4%、17.8%、0.0%;40.2%、12.6%、12.6%;17.7%、7.1%、0.0%,手术切除组生存情况明显好于其他两组(P<0.05)。结论不建议所有患者术前均引流可减黄,且可以不过分强调R0切除。胆道引流可一定程度改善预后,但近远期胆道感染相关并发症发生率较高。Objective To evaluate the clinical effects of surgical treatments for Hilar Cholangiocarcinoma. Methods The clinical information of 156 patients from March 2007 to March 2012 were retrospectively analyzed. The patients were divided into surgical resection group, biliary drainage group and palliative treatment group. The hospital- stay morbidity and mortality, and survival time were analyzed. Results Forty-five patients underwent surgical resection, 78 biliary drainage, and 33 palliative treatments. The radical resection rate was 23.1% （36/156）. The 1-, 3- and 5-year cumulative survival rates were 64.4%-17.8%-0.0%, 40.2%-12.6%-12.6%, and 17.7%-7.1%-0.0% in each group respectively. The surgical resection group had better survival situation than the other two groups （P 〈 0.05）. Conclusions Compulsive pre-resection bile duct drainage is not suggested, and R0 resection should not be over emphasized. Biliary drainage may prolong survival time. However, it may cause high biliary infection-related morbidity in the short and long terms.

关 键 词：肝门胆管癌 外科治疗 评价 

分 类 号：R735.8[医药卫生—肿瘤]