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华西医学  2013 

肝门胆管癌外科治疗疗效评价

DOI: 10.7507/1002-0179.20130437, PP. 1387-1389

Keywords: 肝门胆管癌,外科治疗,评价

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Abstract:

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。

References

[1]  [ 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]  [ 2 ] Blechacz B, Gores GJ. Cholangiocarcinoma: advances in pathogenesis, diagnosis, and treatment[J]. Hepatology, 2008, 48(1): 308-321.
[3]  [ 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]  [ 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]  [ 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]  [ 6 ] Nishio H, Nagino M, Nimura Y. Surgical management of hilar cholangiocarcinoma: the Nagoya experience[J]. HPB (Oxford), 2005, 7(4): 259-262.
[7]  [ 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]  [ 8 ] Hemming AW, Kim RD, Mekeel KL, et al. Portal vein resection for hilar cholangiocarcinoma[J]. Am Surg, 2006, 72(7): 599-604.
[9]  [ 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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