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在日本肝外胆管癌的发生率,从1964年尸解的0.6%增至1973年的1.72%。1974年以来肝外胆管癌在胃肠道肿瘤中占第四位。作者复习了长崎大学医学院附属医院在最近13.5年中手术治疗的86例肝外胆管癌病例。手术时的平均年龄为61.8岁(5～83岁)。男:女为2.3∶1。住院时的主要症状是黄疸和腹痛,有黄疸者占93%,无黄疸有腹痛者占7%。73例(84.9%)在术前经PTC、ERCP和动脉造影确诊。其余病例在术中或术后经组织学检查或尸解确诊。PTC取得的胆汁做细胞学检查,37/58例阳性。合并胆管结石者有6例。根据日本胆道外科协会提出的原则,按癌瘤的部位分为五组:(1)肝管组:肿瘤在左或右肝管,11例(12.8%)。(2)上(?)/3组:肿瘤在左右肝管的汇合部和肝总管的上半部,33例(38.4%)。(3)中1/3组:肿瘤在下半肝总管和胰腺以上的胆总管,17例(19.8%)。(4)下1/3组:肿瘤在胰腺段胆总管,17例(19.8%)。(5)扩散组:肿瘤在三个或更多的部
The incidence of extrahepatic cholangiocarcinoma in Japan increased from 0.6% in autopsy in 1964 to 1.72% in 1973. Since 1974, extrahepatic cholangiocarcinoma has occupied the fourth place among gastrointestinal cancers. The author reviewed 86 cases of extrahepatic cholangiocarcinoma treated surgically in the hospital of the Nagasaki University School of Medicine in the last 13.5 years. The average age at the time of surgery was 61.8 years (5-83 years old). Male: Female is 2.3:1. The main symptoms of hospitalization were jaundice and abdominal pain. 93% of them had jaundice, and 7% had abdominal pain without jaundice. 73 cases (84.9%) were diagnosed preoperatively by PTC, ERCP, and arteriography. The remaining cases were confirmed by intraoperative or postoperative histological examination or autopsy. The cytology of bile obtained by PTC was positive in 37/58 cases. There were 6 cases with biliary stones. According to the principles proposed by the Japanese Biliary Surgery Association, the cancerous sites were divided into five groups: (1) The hepatic duct group: the tumor was in the left or right hepatic duct, 11 cases (12.8%). (2) Upper (?)/3 groups: The tumors were in the confluence of the left and right hepatic ducts and the upper half of the common hepatic ducts, 33 cases (38.4%). (3) In the middle 1/3 group: Tumors were found in the lower common hepatic duct and the common bile duct above the pancreas, 17 cases (19.8%). (4) In the lower 1/3 group: Tumor in the common bile duct of the pancreas, 17 cases (19.8%). (5) Diffusion group: tumors in three or more