论文部分内容阅读
目的探讨肝门部胆管癌的临床诊断和外科治疗对患者预后的影响。方法对1995年1月～2006年12月经手术和病理确诊的78例肝门部胆管癌的临床特征、手术方式、并发症、生存率等进行回顾性分析总结。结果78例中手术切除38例,其中根治性切除16例,姑息性切除22例,行手术胆管引流40例,其中内引流11例,外引流29例。随访50例中根治性切除组1、3、5年生存率为78.0%、56.0%、18.0%,姑息性切除组1、3年生存率为70.4%、12.3%,无5年生存。内引流组和外引流组1年生存率为47.9%和28.6%,无3年生存。结论B超检查联合CT或MRI,对肝门部胆管癌可基本明确诊断;根治切除是提高肝门部胆管癌远期存活率的有效手段。
Objective To investigate the effect of clinical diagnosis and surgical treatment of hilar cholangiocarcinoma on the prognosis of patients. Methods The clinical features, surgical methods, complications and survival rate of 78 cases of hilar cholangiocarcinoma confirmed by operation and pathology from January 1995 to December 2006 were analyzed retrospectively. Results Of 78 cases, 38 cases were surgically removed, of which 16 cases were treated by radical resection, 22 cases were treated by palliative resection and 40 cases were treated by surgical bile duct drainage. Among them, 11 were internal drainage and 29 were external drainage. The 1, 3, 5-year survival rate was 78.0%, 56.0% and 18.0% in the 50 cases of radical resection. The 1-year and 3-year survival rates of the palliative resection group were 70.4% and 12.3%, respectively, with no 5-year survival. The 1-year survival rates of internal drainage group and external drainage group were 47.9% and 28.6%, respectively, with no 3-year survival. Conclusions B-ultrasound combined with CT or MRI can basically confirm the diagnosis of hilar cholangiocarcinoma. Radical resection is an effective way to improve the long-term survival rate of hilar cholangiocarcinoma.