肝吸虫病合并胆管癌29例报告  

A report of 29 cases of clonorchiasis complicated with cholangiocarcinoma

作　　者：王友顺[1] 陈保华[1] 余力[1] 厉周[1] 

机构地区：[1]第一军医大学附属珠江医院肝胆外科,广州市510282

出　　处：《中华肝胆外科杂志》2003年第10期611-613,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　探讨肝吸虫病与胆管癌之间的病理机制及其临床诊治经验。方法　回顾性分析肝吸虫病合并胆管癌病人 2 9例。结果　男性 2 1例 ,女性 8例 ,平均年龄 6 2 5岁 ,高分化腺癌 13例(44 8% ) ,低分化腺癌 16例 (5 5 2 % )。根治性肿瘤切除术 2 1例 (72 4 % ) ,姑息性内引流术 5例 ,剖腹探查活检术 3例 ;生存 10年者 2例 ,5年者 3例 ,3年者 6例 ,1年者 13例 ,6个月者 4例 ,3个月者1例。结论　 (1)肝吸虫感染、肝吸虫卵的沉积是诱发胆管上皮细胞增生、癌变的重要因素 ;(2 )本病诊断有赖于病理 ,术中病理活检的广泛应用是提高其诊断符合率的有效措施 ;(3)治疗仍是以手术为主的综合治疗 ,能根治性切除则预后佳 ,不能根治者解决胆道梗阻也可延长生命。Objective To explore the pathogenesis of clonorchiasis complicated with cholangiocarcinoma and summarize experience in its treatment. Methods The clinical data of 29 patients with clonorchiasis complicated with cholangiocarcinoma treated in our hospital were retrospectively analyzed. Results Of the 29 patients with an average age of 62.5, 21 were male and 8 female. Thirteen of them (44.8%) were with highly differentiated adenocarcinoma and 16 (55.2%) with lowly differentiated one. Twenty-one patients (72.4%) received radical resection, 5 palliative internal drainage and 3 laparotomy for exploration and biopsy. The survival time was 10 years for 2 patients, 5 years for 3, 3 years for 6, 1 year for 13, 6 months for 4 and 3 months for 1. Conclusions 1) Clonorchiasis infestation is an important reason for cholangiocarcinoma; 2) The diagnosis of this disease depends on pathological examination. Biopsy during the operation is an effective method for increasing the right rate of its diagnosis. 3) Operation is of the first choice for treatment of this disease and the best prognosis depends on whether the tumor is resected or not. Meanwhile, removal of the biliary duct obstruction can prolong the survival time of patients.

关 键 词：肝吸虫病 胆管癌 诊断 临床资料 胆结石 胆管扩张 

分 类 号：R735.8[医药卫生—肿瘤]