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目的探讨肝门部胆管癌的诊断及各种不同外科治疗方法间的疗效差异。方法回顾漯河市第二人民医院2002—2010年手术治疗的82例肝门部胆管癌的临床资料;82例病人中男56例,女26例,年龄30~69岁,平均年龄52岁,根据癌肿侵犯程度及部位行不同手术治疗,对比疗效及预后。结果 82例病人中,27例行不同方式的手术切除,切除率为32.9%,其中根治性切除14例(51.9),姑息性切除13例(48.1%)联合肝切除者17例(63%),其中根治性切除组合并肝切除者10例(71.4),姑息性切除组中兼行肝切除者4例(30.8%)。切除组1、3年生存率分别为79.9%、39.1%,引流组1、2年生存率分别为23.2%、11.1%,无三年生存者。结论肝门部胆管癌应早期诊断,争取手术切除,合理的联合肝叶切除能提高根治性切除率,改善预后。
Objective To investigate the diagnosis of hilar cholangiocarcinoma and the difference of curative effect between different surgical methods. Methods The clinical data of 82 cases of hilar cholangiocarcinoma surgically treated in the Second People’s Hospital of Luohe from 2002 to 2010 were retrospectively reviewed. Among the 82 patients, 56 were male and 26 were female, aged from 30 to 69 years with a mean age of 52 years. The extent of cancer invasion and different surgical treatment of the site, the comparison of efficacy and prognosis. Results Of the 82 patients, 27 had undergone different surgical resections, with a resection rate of 32.9%. Radical resection was performed in 14 patients (51.9), palliative resection in 13 patients (48.1%) and hepatectomy in 17 patients (63%). Among them, 10 (71.4) patients underwent radical resection and hepatectomy, and 4 (30.8%) patients underwent hepatectomy in the palliative resection group. The 1-year and 3-year survival rates of the resection group were 79.9% and 39.1%, respectively. The 1-year and 2-year survival rates of the drainage group were 23.2% and 11.1% respectively, with no three-year survival. Conclusions Hilar cholangiocarcinoma should be diagnosed early to seek surgical resection. A reasonable combined hepatectomy can improve radical resection rate and improve prognosis.