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目的:探讨肝门部胆管癌诊断方法、临床特点和外科治疗效果。方法:回顾性分析87例肝门部胆管癌患者的临床资料及随访结果。结果:87例患者行根治性手术26例,姑息性手术17例,引流术14例,单纯开腹探查术12例,经皮肝穿刺胆管引流术13例,逆行胰胆管造影+支架植入术5例。行根治性手术者1,3 a生存率分别为81.0%,52.3%;行姑息性手术者1,3 a分别为生存率45.5%,27.2%;根治手术组生存率高于姑息手术组(P<0.05);年龄、血清总胆红素、Bismuth-Corlette分型、手术方式、淋巴结转移、肿瘤分期对患者预后有影响。结论:多项检查联合应用可提高肝门部胆管癌诊断率;手术切除是治疗肝门部胆管癌的有效方法;掌握个体化治疗原则对改善患者生存质量和提高生存期有重要意义。
Objective: To investigate the diagnosis, clinical features and surgical treatment of hilar cholangiocarcinoma. Methods: A retrospective analysis of 87 cases of hilar cholangiocarcinoma in patients with clinical data and follow-up results. Results: Totally 87 patients underwent radical surgery in 26 cases, palliative surgery in 17 cases, drainage in 14 cases, simple laparotomy in 12 cases, percutaneous transhepatic biliary drainage in 13 cases, retrograde cholangiopancreatography plus stent implantation 5 cases. The survival rates of 1,3-year-old patients undergoing radical surgery were 81.0% and 52.3%, respectively, while those of patients undergoing palliative surgery were 45.5% and 27.2%, respectively. The survival rate of radical surgery group was higher than that of palliative surgery group <0.05). The age, serum total bilirubin, Bismuth-Corlette classification, operation method, lymph node metastasis and tumor staging had an impact on the prognosis of patients. Conclusion: The combined application of multiple tests can improve the diagnosis rate of hilar cholangiocarcinoma. Surgical resection is an effective method to treat hilar cholangiocarcinoma. It is of great significance to grasp the principle of individualized therapy to improve the quality of life and improve the survival of patients.