中肝切除在Bismuth Ⅳ型肝门部胆管癌外科手术中的应用  

Application of middle hepatectomy in the surgical operation of Bismuth type Ⅳ hilar cholangiocarcinoma

作　　者：王志东[1] 冷开明 钟翔宇[1] 王浩[1] 康鹏程[1] 徐艺[1] 郑汪洋 崔云甫[1] Wang Zhidong;Leng Kaiming;Zhong Xiangyu;Wang Hao;Kang Pengcheng;Xu Yi;Zheng Wangyang;Cui Yunfu(Department of Hepatopancreatobiliary Surgery,Second Affiliated Hospital of Harbin Medical University,Helongjiang Harbin 150081,China;Department of Hepatobiliary Surgery,Qingdao Municipal Hospital,Shandong Qingdao 266071,China)

机构地区：[1]哈尔滨医科大学附属第二医院胆胰外科,黑龙江哈尔滨150081 [2]青岛市市立医院肝胆外科,山东青岛266071

出　　处：《腹部外科》2019年第6期431-434,共4页Journal of Abdominal Surgery

基　　金：国家自然科学基金青年科学基金项目(81902431)

摘　　要：目的探讨中肝切除在Bismuth Ⅳ型肝门部胆管癌治疗中的应用价值。方法回顾性分析2015年1月至2019年4月间7例Bismuth Ⅳ型肝门部胆管癌行中肝切除病人的临床资料。结果全组病人无围手术期死亡。R0切除6例,R1切除1例。术后主要并发症:A级胆瘘4例,切口感染1例,右侧胸腔积液2例。随访时间2~37个月,平均22个月。截至2019年6月28日,3例病人术后分别随访2、11、37个月,未出现复发和远处转移。结论中肝切除是一种兼顾根治性和保留功能肝体积的手术方法,有利于减少术后肝衰竭发生率,对于不伴有血管侵犯的部分Bismuth Ⅳ型肝门部胆管癌病人是一种较好的选择。Objective To investigate the clinical value of mesohepatectomy for Bismuth type Ⅳ hilar cholangiocarcinoma(HC).Methods The clinical data of 7 patients with Bismuth type Ⅳ HC were analyzed respectively.Results There was no death occurred during the period of 30 days after operation.6 cases underwent R0 resection and 1 cases experienced R1 resection.The main postoperative complications included grade A bile leakage in 4 cases,incision infection in 1 cases,and right pleural effusion in 2 cases.The follow-up period ranged from 2 to 37 months,with an average of 22 months.As of June 28,2019,3 patients were followed up for 2,11 and 37 months,respectively.No recurrence or distant metastasis occurred.Conclusion Mesohepatectomy is a curative and functional liver volume preservation method,which is beneficial to reduce the incidence of postoperative liver failure.It is a good choice for some patients with Bismuth Ⅳ HC without vascular invasion.

关 键 词：肝门部胆管癌 BISMUTH 中肝切除 

分 类 号：R730.4[医药卫生—肿瘤] R657.3[医药卫生—临床医学]