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目的对肝胆管结石合并肝胆管癌的临床特征以及治疗要点进行深入探讨和剖析。方法随机选取肝胆管结石合并肝胆管癌患者22例作为研究对象,对其临床表现、类型、检查以及治疗方法进行回顾性分析。结果该22例患者中在术前确诊为肝胆管癌患者6例,术中确诊13例,术后确诊3例;其中4例患者为肝门部肝胆管癌,16例患者为左肝胆管癌,2例患者为右肝胆管癌;6例患者采取根治切除术,16例患者采取姑息性手术治疗;术后8例患者发生并发症;经随访显示,根治术患者中存活1年以上、2年以上、3年以上患者分别为6例、4例、2例;姑息性手术患者中存活1年以上、2年以上、3年以上患者分别为8例、2例、0例。两种手术方法生存率比较差异有统计学意义(P<0.05)。结论对于患有肝胆管结石患者而言,尽快进行详细检查及手术等确诊疾病是否发展为肝胆管癌是极为关键的,同时对于确诊为肝胆管结石合并肝胆管癌患者采取根治切除术能够明显提高生存率。
Objective To investigate and analyze the clinical features and treatment points of hepatolithiasis complicated with hepatobiliary and cholangiocarcinoma. Methods Twenty-two patients with cholangiolithiasis and cholangiocarcinoma were selected randomly as the research object, and their clinical manifestations, types, examinations and treatment methods were retrospectively analyzed. Results Of the 22 patients, 6 were diagnosed as cholangiocarcinoma before operation, 13 were diagnosed intraoperatively and 3 were diagnosed postoperatively. Among them, 4 were hepatocellular cholangiocarcinoma and 16 were cholangiocarcinoma , 2 patients with right cholangiocarcinoma; 6 patients underwent radical resection, 16 patients were treated with palliative surgery; 8 patients after surgery complications; after follow-up showed that patients survived more than 1 year radical surgery, 2 More than 3 years of age patients were 6 cases, 4 cases, 2 cases; palliative surgery patients survived for more than 1 year, more than 2 years, 3 years were 8 cases, 2 cases, 0 cases. The survival rates of the two surgical methods were significantly different (P <0.05). Conclusions For patients with hepatolithiasis, it is crucial to diagnose whether hepatociliary disease is diagnosed as soon as possible after detailed examination and surgery, and radical resection of hepatolithiasis with cholangiocarcinoma can be significantly improved Survival rate.