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目的:探讨不同手术方式治疗肝门部胆管癌的效果及其对术后放疗的影响。方法:回顾性分析我科自2008年6月至2012年6月间收治的60例肝门部胆管癌患者的临床资料,根据手术方式不同,将所选病例分为两组,其中26例接受根治性切除术,34例患者采用姑息性手术进行治疗。对比不同手术方式下放疗后患者生存情况。结果:围手术期死亡1例。两组患者各有2例患者失访。随访的23例根治手术患者1、3、5年间的生存率为19(82.6%)、10(43.5%)、2(8.7%);32例姑息性手术患者1、3、5年间的生存率为15(46.9%)、4(12.4%)、0(0%)。根治性手术后患者1、3、5年间的生存率显著性高于姑息性手术治疗的患者,差异具有统计学意义(P<0.05)。结论:通过术前影像学诊断,选择合理的手术方式,联合术后放疗,可有效延长肝门部胆管癌患者的生存时间。
Objective: To explore the different surgical treatment of hilar cholangiocarcinoma and its effect on postoperative radiotherapy. Methods: The clinical data of 60 cases of hilar cholangiocarcinoma admitted to our department from June 2008 to June 2012 were retrospectively analyzed. According to the different operation methods, the selected cases were divided into two groups, of which 26 cases accepted Radical resection and 34 patients were treated with palliative surgery. To compare the survival of patients after radiotherapy under different surgical methods. Results: Perioperative death in 1 case. Two patients in each group had two patients lost. The survival rates of the 23 patients who underwent radical surgery at the first, third and fifth year were 19 (82.6%), 10 (43.5%) and 2 (8.7%), respectively. The survival rates of the 32 patients who underwent palliative surgery at 1, 3 and 5 years 15 (46.9%), 4 (12.4%), 0 (0%). The survival rate of patients after radical surgery in one, three, and five years was significantly higher than that of palliative surgery patients, the difference was statistically significant (P <0.05). Conclusion: Preoperative imaging diagnosis, selection of reasonable surgical methods, combined with postoperative radiotherapy, can effectively extend the survival time of patients with hilar cholangiocarcinoma.