不同手术方式治疗肝门部胆管癌患者的近期及远期疗效  

Short-term and long-term efficacy of different surgical methods in treatment of patients with hilar cholangiocarcinoma

作　　者：戴兵[1] 吕新远[1] 张林娇 刘驰[1] 白璐璐 DAI Bing;LYU Xinyuan;ZHANG Linjiao;LIU Chi;BAI Lulu(Department of Hepatic General Surgery,Nanyang Central Hospital,Nanyang 473000,He’nan,China)

机构地区：[1]南阳市中心医院肝脏普外科,河南南阳473000

出　　处：《癌症进展》2023年第14期1583-1586,共4页Oncology Progress

摘　　要：目的 探讨不同手术方式治疗肝门部胆管癌患者的近期及远期疗效。方法 根据手术治疗方式的不同将149例肝门部胆管癌患者分为根治性切除术组(n=49)、经皮肝穿刺胆道引流组(n=49)、内镜下金属支架引流组(n=51)。比较3组患者的肝功能指标[丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)、总胆红素(TBIL)]、术后并发症发生率及生存率。结果 术后1周,3组患者的ALT、ALP、TBIL水平均低于本组术前,根治性切除术组患者的ALT、ALP、TBIL水平均低于经皮肝穿刺胆道引流组和内镜下金属支架引流组,差异均有统计学意义(P﹤0.05)。根治性切除术组患者的并发症总发生率为30.61%,高于经皮肝穿刺胆道引流组患者的12.24%和内镜下金属支架引流组患者的11.76%,差异均有统计学意义(P﹤0.05)。根治性切除术组患者的1、3、5年生存率均高于经皮肝穿刺胆道引流组,内镜下金属支架引流组患者的1、3年生存率均高于经皮肝穿刺胆道引流组,差异均有统计学意义(P﹤0.05)。结论 肝门部胆管癌患者的近期及远期疗效与手术方式有关,根治性切除术仍是患者获得长期生存最重要的措施。Objective To investigate the short-term and long-term efficacy of different surgical methods in treatment of patients with hilar cholangiocarcinoma.Method A total of 149 patients with hilar cholangiocarcinoma were divided into radical resection group(n=49),percutaneous transhepatic choledochus drainage group(n=49),and endoscopic metal stent drainage group(n=51).The liver function indicators[alanine aminotransferase(ALT),alkaline phosphatase(ALP),total bilirubin(TBIL)],postoperative complications,and survival rate were compared between the three groups.Result One week after the operation,the levels of ALT,ALP,and TBIL in the three groups were lower than those before the oper-ation,and the levels of the three indicators in the radical resection group were lower than those in the percutaneous tran-shepatic choledochus drainage group and endoscopic metal stent drainage group,and the differences were statistically sig-nificant(P<0.05).The total incidence of complications in the radical resection group was 30.61%,which was higher than 12.24%in the percutaneous transhepatic choledochus drainage group and 11.76%in the endoscopic metal stent drainage group,and the differences were statistically significant(P<0.05).The 1-,3-,and 5-year survival rates of patients in the radical resection group were higher than those in the percutaneous transhepatic choledochus drainage group,and the 1-and 3-year survival rates of patients in the endoscopic metal stent drainage group were higher than those in the percutane-ous transhepatic choledochus drainage group,and the differences were statistically significant(P<0.05).Conclusion The short-term and long-term efficacy of patients with hilar cholangiocarcinoma is related to surgical treatment method,and radical resection is still the most important measure for patients to obtain long-term survival.

关 键 词：根治性切除 经皮肝穿刺胆道引流 内镜下金属支架引流 肝门部胆管癌 近期疗效 远期疗效 

分 类 号：R735.8[医药卫生—肿瘤]