肝叶切除与肝门胆管癌根治术联合应用的临床价值研究  

The Clinical Value of the Hepatic Lobectomy Combined with Radical Resection for Perihilar Cholangiocarcinoma

作　　者：张雷[1] 王林[1] 耿智敏[1] 万永[1] 孟凡迪[1] 孟宪魁[1] ZHANG Lei WANG Lin GENC Zhi-min WAN Yong MENG Fan-di MENG Xian-kui(Department of Geratic Surgery, The First Affiliated Hospital of Xi ＇an Jiaotong University, Xi ＇an 710061, Shaanxi, China)

机构地区：[1]西安交通大学第一附属医院老年外科,陕西西安710061

出　　处：《中国现代手术学杂志》2017年第1期5-8,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨肝叶切除与肝门胆管癌根治术联合应用的临床价值。方法选取2010年1月~2013年1月我院收治的72例肝门胆管癌患者作为研究对象,按照手术方式分为两组:对照组(n=36)行常规肝门胆管癌根治术治疗,观察组(n=36)行肝叶切除联合肝门胆管癌根治术治疗。比较两组患者手术情况、根治性切除率、术后并发症发生率及1、2、3年生存率。结果观察组患者手术时间(305.5±16.7)min,术中出血量(341.6±20.7)ml,高于对照组的(244.3±15.8)min和(67.5±4.1)ml,差异均有统计学意义(P<0.05),而两组住院时间比较无统计学差异(P>0.05)。观察组根治性切除率达77.78%,高于对照组的27.78%,术后并发症发生率为36.1%(13/36),高于对照组的13.9%(5/36),差异均有统计学意义(P<0.05)。观察组1、2、3年生存率分别为83.3%、50%及33.3%,高于对照组的52.8%、22.2%及8.3%,差异有统计学意义(P<0.05)。结论肝叶切除与肝门胆管癌根治术联合应用能有效提高根治性切除率,提高患者生存率,临床应用价值显著。Objective To investigate the clinical value of the hepatic lobectomy combined with radical resection of perihilar cholangiocarcinoma. Methods From January 2010 to January 2013, a total of 72 patients with perihilar cholangiocarcinoma in our hospital were analyzed retrospectively. All 72 patients were divided into two groups according to surgical procedure： The control group （n = 36） was treated with radical resection of perihilar cholangiocarcinoma, and the observation group （ n = 36） was treated with hepatic lobectomy combined with radical resection of peri hilar cholangiocareinoma. The operation result, radical resection rate, postoperative complication rate and 1 -, 2-, 3 year survival rate were compared between two groups. Results The operation time and intra-operative blood loss in the observation group were significantly higher than those in the control group （ （ 305.5 ± 16.7 ） rain vs. （244.3 ±15.8 ） min, （341.6 ± 20.7 ） ml vs. （67.5 ± 4.1 ） ml, P 〈 0.05 ）. There was no statistical difference in the hospital stays between two groups （ P 〉 0.05 ）. The radical resection rate of the observation group was 77.8% , and was significantly higher than 27.8% of the control group （ P 〈 0.05 ）. The postoperative complication rate of the observation group was significantly higher than that of the control group （36.1% vs. 13.9% , P 〈 0.05）. The survival rate of 1-, 2-, 3 year was 83.3% , 50% and 33.3% respectively in the observation group, and was remarkable higher than 52.8%, 22.2% and 8.3% respectively in control group （P 〈 0. 05 ）. Conclusion The surgery of hepatic lobectomy combined with radical resection can play an important role in improving the radical resection rate effectively and increasing the survival rate for perihilar cholangiocarcinoma.

关 键 词：胆管肿瘤 肝叶切除术 肝门胆管癌根治术 

分 类 号：R735.8[医药卫生—肿瘤]