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目的探讨肝门部胆管癌的临床诊断和外科治疗方法。方法对某院2004年1月～2009年12月收治的59例肝门部胆管癌的临床资料进行回顾性分析。结果按Bismuth-Corlette临床分型:Ⅰ型7例,Ⅱ型9例,Ⅲa型11例,Ⅲb16例Ⅳ型16例。根治性切除29例,姑息性切除9例,内引流术11例;单纯置管外引流术5例;剖腹探查仅行腹腔病灶活检术2例,非手术治疗3例。根治性切除者,平均生存期为26.2月;姑息性切除者,平均生存期为14.2个月;仅行内外引流术者,平均生存期为13.9月;非手术治疗者,平均生存期4.2月。结论肝门部胆管癌的诊断主要依靠影像学检查及肿瘤标志物,手术治疗是肝门部胆管癌的首选治疗方法。
Objective To investigate the clinical diagnosis and surgical treatment of hilar cholangiocarcinoma. Methods The clinical data of 59 cases of hilar cholangiocarcinoma from January 2004 to December 2009 in a hospital were analyzed retrospectively. Results According to the clinical classification of Bismuth-Corlette, there were 7 cases of type Ⅰ, 9 cases of type Ⅱ, 11 cases of type Ⅲa and 16 cases of type Ⅳ of type Ⅲb. There were 29 cases of radical resection, 9 cases of palliative resection, 11 cases of internal drainage, 5 cases of simple catheter drainage, 2 cases of peritoneal laparoscopic biopsy and 3 cases of non-surgical treatment. Radical resection, the average survival time was 26.2 months; palliative resection, the average survival was 14.2 months; only internal and external drainage of those with an average survival of 13.9 months; non-surgical treatment, the average survival of 4.2 months. Conclusions The diagnosis of hilar cholangiocarcinoma mainly depends on imaging and tumor markers. Surgical treatment is the first choice of treatment for hilar cholangiocarcinoma.