内镜在胆道梗阻型肝细胞性癌处理中的作用(附12例报告)  

THE EFFECT OF ENDOSCOPE ON THE TREATMENT OF HEPATOCELLULLAR CARCINOMA COMBINED WITH BILLIARY TRACT OBSTRUCTION

作　　者：薛平[1] 陈德[1] 胡以则[1] 卢海武[1] 尹巧群[1] 张端[1] 

机构地区：[1]广州医学院第二附属医院肝胆外科,510260

出　　处：《中国内镜杂志》2001年第1期22-23,共2页China Journal of Endoscopy

摘　　要：目的 :探讨内镜在胆道梗阻型肝细胞性肝癌处理中的作用。方法 :回顾性分析 1997年 5月～ 2 0 0 0年 5月共 12例胆道梗阻型肝细胞性癌患者内镜处理的结果。其中原发性肝癌并胆管内癌栓 5例 ,原发性肝癌并胆管结石 7例。进行内镜处理 +切肝 7例。内镜处理 +TAE +切肝 1例 ;单纯内镜处理 3例。结果 :手术死亡 1例 ,失访 2例 ,共 3例 ,占 2 5 % ,余下 9例中 ,存活 3～ 6个月 2例 ,存活半年～ 1年 3例 ,存活 1～ 2年 3例 ,存活 2例以上 1例 ,存活 1年以上的均为内镜处理加手术切肝的病人。结论 :对于肝癌出现黄疸 ,治疗上应区别对待 ,不能一概而论 ,应增强对本病的认识 ,争取在胆道梗阻的早期 ,进行积极的内镜处理 ,配合正解的手术、或介入放射等综合治疗 ,可获得良好的治疗效果。Objective:To study the effect of endoscope on the treatment of Hepatocellular Carcinoma (HCC) combined with biliary tract obstrucition (BTO).Methods:We have analyzed retrospectively the results of twelve patients suffering from HCC combined with BTO from 5,1990 to 5,2000.Among these cases,various reasons were found.5 of them were intrabilitary cancer embolus,7 were billary calculus.7 of them were treated with endoscope and following surgical resection,1 was treated with endoscope、TAE and resection,the 3 rest of them were solely treated with endoscope.Results:Of all the 12 cases,1 died of resection,2 failed to follow the survey,these 3 cases above took 25%;among the rest of 9 cases,2 of them survived for 3 to 6 months,3 for half to 1 year,3 for 1 to 2 year,1 for at least 2 years.Those cases suviving for more than 1 year were received surgical resection.Conclusions:We should have no fixed way but to deal with each patient of HCC combined with BTO on his/her merits.As our recognition towards them began accumulating,we found that,in the early stage of obstruction,active endoscopic treatment would prove to be preferable.If combined with other therapy such as surgical resection and TAE,Endoscopy would improve the curative effect of HCC combined with BTO substantially.

关 键 词：肝细胞性肝癌 胆道梗阻 内镜处理 

分 类 号：R735.7[医药卫生—肿瘤]