肝细胞癌合并胆管癌栓29例手术分析  

Surgical analysis of 29 cases of hepatocellular carcinoma with bile duct tumor thrombus

作　　者：金铨 宋研[1] 禹亚彬[1] 徐建波[1] 赵江生 陈国峰[1] 张笑天 祁付珍[1] JIN Quan;SONG Yan;YU Yabin;XU Jianbo;ZHAO Jiangsheng;CHEN Guofeng;ZHANG Xiaotian;QI Fuzhen(Department of Hepatobiliary and Pancreatic Surgery,the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University,Huai'an,Jiangsu 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院肝胆胰外科,江苏淮安223300

出　　处：《中国临床研究》2024年第6期872-875,共4页Chinese Journal of Clinical Research

基　　金：国家自然科学基金青年科学基金项目(82203722)。

摘　　要：目的探讨肝细胞癌(HCC)合并胆管癌栓的手术治疗效果以及Satoh分型对患者预后的影响。方法对2010年1月至2016年10月南京医科大学附属淮安第一医院收治的29例HCC合并胆管癌栓行根治性手术(解剖性肝切除/不规则肝切除+胆管切开取栓术)患者的病例资料进行回顾性分析;根据Satoh分型,其中Ⅰ型9例,Ⅱ型6例,Ⅲ型14例。结果所有29例患者手术均顺利完成,围手术期死亡1例(Ⅲ型),失访1例(Ⅱ型);患者术后总体1、3年生存率为60.7%、53.6%;Ⅰ、Ⅱ、Ⅲ型术后1年无瘤生存比例分别为6/9、3/5和6/14,术后3年无瘤生存比例分别为5/9、2/5和3/14。结论对于HCC合并胆管癌栓患者,积极行解剖性肝切除/不规则肝切除+胆管切开取栓治疗可取得良好手术效果。Satoh分型对患者预后判断具有一定指导意义。Objective To investigate the surgical treatment effect of hepatocellular carcinoma(HCC)combined with bile duct tumor thrombus and the impact of Satoh classification on patient prognosis.Methods The clinical data of 29 patients with HCC combined with bile duct tumor thrombus who underwent radical surgery(anatomical liver resection/irregular liver resection+bile duct incision and embolectomy)in the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from January 2010 to October 2016 were retrospectively analyzed.According to Satoh classification,there were 9 cases of typeⅠ,6 cases of typeⅡ,and 14 cases of typeⅢ.Results All 29 patients successfully completed the operation,with perioperative death in 1 case(typeⅢ)and loss to follow-up in 1 case(typeⅡ).The overall 1-year and 3-year survival rates of patients after surgery were 60.7%and 53.6%,respectively.The 1-year disease-free survival rates of typesⅠ,Ⅱ,andⅢwere 6/9,3/5,and 6/14,respectively,and the 3-year disease-free survival rates were 5/9,2/5,and 3/14,respectively.Conclusion For HCC patients combined with bile duct tumor thrombus,active anatomical liver resection/irregular liver resection+bile duct incision and embolectomy can achieve good surgical results.Satoh classification has certain guiding significance for judging patient prognosis.

关 键 词：肝细胞癌 胆管癌栓 肝切除 胆管切开取栓术 Satoh分型 

分 类 号：R735.7[医药卫生—肿瘤]