肝门胆管癌外科治疗疗效评价_《华西医学》

作者：

宗帝 ^1,2 ,  曾勇 ¹

1四川大学华西医院肝胆胰外科（成都，610041）;2四川省医学科学院·四川省人民医院整形外科;

关键词：

肝门胆管癌外科治疗评价

DOI：

10.7507/1002-0179.20130437

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　对肝门胆管癌外科治疗疗效进行评价。方法　回顾分析2007年3月－2012年3月收治的156例肝门胆管癌患者的临床资料。按手术方式将患者分为手术切除组（n=45）、胆道引流组（n=78）和姑息治疗组（n=33），并对住院期间并发症发生率、病死率及生存时间等进行分析。结果　156例患者根治性切率为23.1%不同治疗方式住院期间病死率差异无统计学意义（P＜0.05）；手术治疗组与姑息治疗组并发症发生率差异有统计学意义（P＜0.05）。手术切除组、胆道引流组、姑息治疗组的1、3、5年累积生存率分别为64.4%、17.8%、0.0%；40.2%、12.6%、12.6%；17.7%、7.1%、0.0%，手术切除组生存情况明显好于其他两组（P＜0.05）。结论　不建议所有患者术前均引流可减黄，且可以不过分强调R0切除。胆道引流可一定程度改善预后，但近远期胆道感染相关并发症发生率较高。

引用本文： 宗帝,曾勇. 肝门胆管癌外科治疗疗效评价. 华西医学, 2013, 28(9): 1387-1389. doi: 10.7507/1002-0179.20130437 复制

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12.	Kennedy TJ, Yopp A, Cin Y, et al. Role of preoperative biliary drainage of liver remnant prior to extended liver resection for hilar cholangiocarcinoma[J]. HPB (Oxford), 2009, 11(5): 445-451.
13.	Nagino M, Kamiya J, Uesaka K, et al. Complications of hepatectomy for hilar cholangiocarcinoma[J]. World J Surg, 2001, 25(10): 1277-1283.
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1. 　李波, 严律南. 肝门胆管癌的诊治进展[J]. 中国普外基础与临床杂志, 2005, 12(4): 356-360.
2. 　Blechacz B, Gores GJ. Cholangiocarcinoma: advances in pathogenesis, diagnosis, and treatment[J]. Hepatology, 2008, 48(1): 308-321.
3. 　顾劲扬, 仇毓东, 周建新, 等. 胆管癌发病机制及治疗进展[J]. 肝胆外科杂志, 2010, 18(5): 385-388.
4. 　万紫微, 李松岗, 杨勇, 等. 肝门部胆管癌外科手术治疗进展[J].肝胆外科杂志, 2009, 17(6): 469-471.
5. 　周宁新, 黄志强, 冯玉泉, 等. 肝门部胆管癌根治性切除手术方式的改进[J]. 中华普通外科杂志, 2001, 16(2): 82-84.
6. 　Nishio H, Nagino M, Nimura Y. Surgical management of hilar cholangiocarcinoma: the Nagoya experience[J]. HPB (Oxford), 2005, 7(4): 259-262.
7. 　Miyazaki M, Kato A, Ito H, et al. Combined vascular resection in operative resection for hilar cholangiocarcinoma: does it work or not?[J]. Surgery, 2007, 141(5): 581-588.
8. 　Hemming AW, Kim RD, Mekeel KL, et al. Portal vein resection for hilar cholangiocarcinoma[J]. Am Surg, 2006, 72(7): 599-604.
9. 　Chen D, Lai JM, Liang LJ, et al. Combination with vascular resection and reconstruction in resection of hilar cholangiocarcinoma[J]. Chin J Surg, 2011, 49(7): 607-610.
10. 　Schiffman SC, Reuter NP, McMasters KM. Overall survival peri-hilar cholangiocarcinoma: R1 resection with curative intent compared to primary endoscopic therapy[J]. J Surg Oncol, 2012, 105(1): 91-96.
11. 　Hidalgo E, Asthana S, Nishio H, et al. Surgery for hilar cholangiocarcinoma: the Leeds experience[J]. Eur J Surg Oncol, 2008, 34(7):787-794.
12. 　Kennedy TJ, Yopp A, Cin Y, et al. Role of preoperative biliary drainage of liver remnant prior to extended liver resection for hilar cholangiocarcinoma[J]. HPB (Oxford), 2009, 11(5): 445-451.
13. 　Nagino M, Kamiya J, Uesaka K, et al. Complications of hepatectomy for hilar cholangiocarcinoma[J]. World J Surg, 2001, 25(10): 1277-1283.
14. 　Khuntikeo N, Pugkhem A, Bhudhisawasdi V, et al. Major hepatic resection for hilar cholangiocarcinoma without preoperative biliary drainage[J]. Asian Pac J Cancer Prev, 2008, 9(1): 83-85.

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肝门胆管癌外科治疗疗效评价

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