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本文作者强调手术切除治疗肝门区胆管癌的重要性且总结出规范的手术方法。作者经外科治疗肝门区胆管瘤122例,其中23例(占19%)为切除性治疗,这23例为本研究的中心。其中男12例,女11例,年龄平均48岁(22～82岁)。按Bismuth-Corlette分类把肿瘤分为四型:Ⅰ型3例,肿瘤侵犯肝管分叉以下肝总管,管腔未完全阻塞,Ⅱ型3例,肿瘤侵犯到脉管分叉部,肝总管完全阻塞;Ⅲ型(a9例,b7例),肿瘤不仅侵犯完全阻塞肝总管,且侵犯扩展到右或左肝管而左或右肝管完好未侵;Ⅳ型4例(其中3例行肝切除+肝移植,未包括在本文),肿瘤侵犯肝总管及左右肝管。外科手术主要依据术中所见的不同类型采用不同的手术切除方法。10例行肿瘤和胰上胆管局部切除。
The author of this article emphasizes the importance of surgical resection of hilar cholangiocarcinoma and summarizes the standard surgical methods. The author surgical treatment of 122 cases of hilar cholangiocarcinoma, of which 23 cases (19%) for the resection of the treatment, these 23 cases of the study center. There were 12 males and 11 females, with an average age of 48 years (22-82 years). According to the Bismuth-Corlette classification, the tumors were divided into four types: type I in 3 cases, the tumor invaded the hepatic duct below the bifurcation of the common hepatic duct, the lumen was not completely blocked, type II in 3 cases, the tumor invaded into the vascular bifurcation, and the hepatic duct was completely Obstruction; type III (a9 cases, b7 cases), tumors not only completely blocked the obstruction of the common hepatic duct, but also extended to the right or left hepatic duct and the left or right hepatic duct intact; 4 cases of type IV (including 3 cases of hepatectomy + Liver transplantation, not included in this article), tumors invade the hepatic duct and left and right hepatic ducts. Surgical procedures rely on different methods of surgical resection, depending on the type of surgery seen. 10 patients underwent local resection of the tumor and upper pancreatic duct.