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目的 :研究肝门部胆管癌根治性切除术方法、疗效。重点探讨提高根治性切除率 ,降低手术死亡率。方法 :总结 1994年 4月～ 2 0 0 0年 4月收治的 18例肝门部胆管癌手术治疗情况 ,8例行根治性切除 ,10例行姑息性手术 ,术后均行腹腔化疗。结果 :18例围手术期无死亡及重大并发症 ,手术根治性切除率为 4 4 .4 % ,同国内文献报道一致。远期随访 :根治性切除 8例 ,患者 1、2、3、5年生存率分别为 10 0 % (8例 )、75 % (6例 )、37.5 %(3例 )、无 5年生存者。姑息性手术 10例 ,患者 1、3年生存率为 1年 2 5 % (2例 )、无 3年生存者。结论 :肝门部胆管癌根治性切除术较姑息性手术获得更优良的生活质量及远期疗效。加强围手术期处理是提高手术切除率 ,减少并发症及死亡率的关键。
Objective: To study the curative effect of radical resection of hilar cholangiocarcinoma. Focus on raising the radical resection rate and reduce the surgical mortality. Methods: 18 cases of hilar cholangiocarcinoma admitted to our hospital from April 1994 to April 2000 were retrospectively reviewed. Eight patients underwent radical resection and 10 patients underwent palliative surgery. All patients received intraperitoneal chemotherapy. Results: There were no deaths and major complications in 18 cases during perioperative period. The radical resection rate was 44.4%, which was consistent with the domestic literature. Long-term follow-up: Radical resection was performed in 8 cases. The 1, 2, 3, 5-year survival rates were 10 0% (8 cases), 75% (6 cases) and 37.5% (3 cases) . Palliative surgery in 10 cases, patients 1, 3-year survival rate was 25% (2 cases), no 3-year survival. Conclusions: Radical resection of hilar cholangiocarcinoma has better quality of life and long-term efficacy than palliative surgery. Strengthening perioperative management is to improve the surgical resection rate, reduce complications and mortality key.