目的 探討肝門部膽管癌2種手術方法的療效。方法 回顧性分析我院1998～2006年期間收治的37例肝門部膽管癌患者的臨床資料。結(jié)果 37例患者中13例行根治性手術切除, 其1年與3年的生存率分別為100%（13/13）和76.92%（10/13），中位生存期為22.43個月； 另24例行姑息性手術（均為肝內(nèi)膽管內(nèi)引流術），其1年與3年生存率分別為54.55%（12/22）和9.09%（2/22），中位生存期為15.42個月。結(jié)論 根治性手術是治療肝門部膽管癌的主要手段； 姑息性手術，如合理的肝內(nèi)膽管內(nèi)引流能改善患者的生存質(zhì)量。
引用本文： 胡超華,胡若男,熊杰,胡少輝,沈雄山,李衛(wèi)民,樊立. 肝門部膽管癌的手術治療. 中國普外基礎與臨床雜志, 2009, 16(11): 873-874. doi: 復制
| 1. | 劉永鋒. 肝門部膽管癌的治療現(xiàn)狀 [Ｊ]. 中國實用外科雜志, 2000; 20(1): 28-31. |
| 2. | Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma [Ｊ]. Ann Surg, 1992; 215(1): 31-38. |
| 3. | 何效東, 董家鴻, 趙曉雷, 等. 肝門部膽管癌的診斷與外科治療 [Ｊ]. 中華肝膽外科雜志, 2008; 14(8): 582-584. |
| 4. | 秦錫虎, 朱峰, 段云飛, 等. 圍肝門膽道手術方式方法的探討附79例報告 [Ｊ]. 中華普外科手術學雜志(電子版), 2008; 2(3): 284-288. |
| 5. | Clary B, Jarnigan W, Pitt H, et al. Hilar cholangiocarcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(3): 298-302. |
| 6. | 梁力建. 重視肝門部膽管癌的診斷和治療 [Ｊ]. 中國實用外科雜志, 2007; 27(5): 351-353. |
| 7. | 黃志強, 黃曉強主編. 肝膽胰外科聚焦 [M]. 第1版. 北京: 人民軍醫(yī)出版社, 2005: 338-350. |
| 8. | Capussotti L, Muratore A, Polastri R, et al ，Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival [Ｊ]. J Am Coll Surg, 2002; 195(5): 641-647. |
| 9. | Tsao JI, Nimura Y, Kamiya J, et al. Management of hilar cholangiocarcinoma: comparison of an American and a Japanese experience [Ｊ]. Ann Surg, 2000; 232(2): 166-174. |
| 10. | Jarnagin WR, Fong Y, DeMatteo RP, et al. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma [Ｊ]. Ann Surg, 2001; 234(4): 507-517; discussion 517-519. |
| 11. | 姜洪池， 陸朝陽. 肝門部膽管癌聯(lián)合尾狀葉根治性切除 [Ｊ]. 中國實用外科雜志, 2007; 27（5）： 364-366. |
| 12. | 黃志強. 肝門部膽管癌外科治療的現(xiàn)狀與展望 [Ｊ]. 中國普外基礎與臨床雜志, 2005; 12(4): 317-320. |
| 13. | Kitagawa Y, Nagino M, Kamiya J, et al，Lymph node metastasis from hilar cholangiocarcinoma: audit of 110 patients who underwent regional and paraaortic node dissection [Ｊ]. Ann Surg, 2001; 233(3): 385-392. |
| 14. | Burke EC, Jarnagin WR, Hochwald SN, et al. Hilar Cholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system [Ｊ]. Ann Surg, 1998; 228(3): 385-394. |
| 15. | 彭淑牖, 李江濤. 肝門部膽管癌的術式選擇 [Ｊ]. 臨床外科雜志, 2006; 14(2): 70-72. |
| 16. | Ebata T, Nagino M, Kamiya J, et al. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases [Ｊ]. Ann Surg, 2003; 238(5): 720-727. |
| 17. | Kondo S, Nimura Y, Hayakawa N, et al. Extensive surgery for carcinoma of the gallbladder [Ｊ]. Br J Surg, 2002; 89(2): 179-184. |
| 18. | 周寧新, 黃志強, 張文智, 等. 402例肝門部膽管癌臨床分型、手術方式與遠期療效的綜合分析 [Ｊ]. 中華外科雜志, 2006; 44(23): 1599-1603. |
| 19. | 周寧新. 肝門部膽管癌擴大根治術及療效評價 [Ｊ]. 中國普外基礎與臨床雜志, 2005; 12(4): 323-324. |
| 20. | Inoue K, Makuuchi M, Takayama T, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma [Ｊ] . Surgery, 2000; 127(5): 498-505. |
| 21. | Kawasaki S, Imamura H, Kobayashi A, et al. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization [Ｊ]. Ann Surg, 2003; 238(1): 84-92. |
- 1. 劉永鋒. 肝門部膽管癌的治療現(xiàn)狀 [Ｊ]. 中國實用外科雜志, 2000; 20(1): 28-31.
- 2. Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma [Ｊ]. Ann Surg, 1992; 215(1): 31-38.
- 3. 何效東, 董家鴻, 趙曉雷, 等. 肝門部膽管癌的診斷與外科治療 [Ｊ]. 中華肝膽外科雜志, 2008; 14(8): 582-584.
- 4. 秦錫虎, 朱峰, 段云飛, 等. 圍肝門膽道手術方式方法的探討附79例報告 [Ｊ]. 中華普外科手術學雜志(電子版), 2008; 2(3): 284-288.
- 5. Clary B, Jarnigan W, Pitt H, et al. Hilar cholangiocarcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(3): 298-302.
- 6. 梁力建. 重視肝門部膽管癌的診斷和治療 [Ｊ]. 中國實用外科雜志, 2007; 27(5): 351-353.
- 7. 黃志強, 黃曉強主編. 肝膽胰外科聚焦 [M]. 第1版. 北京: 人民軍醫(yī)出版社, 2005: 338-350.
- 8. Capussotti L, Muratore A, Polastri R, et al ，Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival [Ｊ]. J Am Coll Surg, 2002; 195(5): 641-647.
- 9. Tsao JI, Nimura Y, Kamiya J, et al. Management of hilar cholangiocarcinoma: comparison of an American and a Japanese experience [Ｊ]. Ann Surg, 2000; 232(2): 166-174.
- 10. Jarnagin WR, Fong Y, DeMatteo RP, et al. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma [Ｊ]. Ann Surg, 2001; 234(4): 507-517; discussion 517-519.
- 11. 姜洪池， 陸朝陽. 肝門部膽管癌聯(lián)合尾狀葉根治性切除 [Ｊ]. 中國實用外科雜志, 2007; 27（5）： 364-366.
- 12. 黃志強. 肝門部膽管癌外科治療的現(xiàn)狀與展望 [Ｊ]. 中國普外基礎與臨床雜志, 2005; 12(4): 317-320.
- 13. Kitagawa Y, Nagino M, Kamiya J, et al，Lymph node metastasis from hilar cholangiocarcinoma: audit of 110 patients who underwent regional and paraaortic node dissection [Ｊ]. Ann Surg, 2001; 233(3): 385-392.
- 14. Burke EC, Jarnagin WR, Hochwald SN, et al. Hilar Cholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system [Ｊ]. Ann Surg, 1998; 228(3): 385-394.
- 15. 彭淑牖, 李江濤. 肝門部膽管癌的術式選擇 [Ｊ]. 臨床外科雜志, 2006; 14(2): 70-72.
- 16. Ebata T, Nagino M, Kamiya J, et al. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases [Ｊ]. Ann Surg, 2003; 238(5): 720-727.
- 17. Kondo S, Nimura Y, Hayakawa N, et al. Extensive surgery for carcinoma of the gallbladder [Ｊ]. Br J Surg, 2002; 89(2): 179-184.
- 18. 周寧新, 黃志強, 張文智, 等. 402例肝門部膽管癌臨床分型、手術方式與遠期療效的綜合分析 [Ｊ]. 中華外科雜志, 2006; 44(23): 1599-1603.
- 19. 周寧新. 肝門部膽管癌擴大根治術及療效評價 [Ｊ]. 中國普外基礎與臨床雜志, 2005; 12(4): 323-324.
- 20. Inoue K, Makuuchi M, Takayama T, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma [Ｊ] . Surgery, 2000; 127(5): 498-505.
- 21. Kawasaki S, Imamura H, Kobayashi A, et al. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization [Ｊ]. Ann Surg, 2003; 238(1): 84-92.