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目的分析肝门部胆管癌的诊断和治疗方法。方法回顾性分析2003年1月至2007年10月收治的12例肝门部胆管癌的临床资料,复习近年来肝门部胆管癌的诊治文献。肝门部胆管癌无临床特异性,肝门部胆管癌切除者行高位胆肠Roux-en-Y吻合术,未切除者行姑息性治疗或内引流、外引流术。结果12例患者中9例行根治性切除,2例行姑息性切除(胆肠内引流),1例因肿瘤广泛转移,阻塞肝门,胆总管中段只有1 cm范围组织较软,行T型管外引流术。结论肝门部胆管癌外科手术治疗是主要手段。根治性切除的原则是:两切断端无癌残留,肝内无转移,无淋巴结转移。术前正确评价可切除性,术中选择正确的术式是获得较好预后的关键。
Objective To analyze the diagnosis and treatment of hilar cholangiocarcinoma. Methods The clinical data of 12 cases of hilar cholangiocarcinoma admitted from January 2003 to October 2007 were reviewed retrospectively. The diagnosis and treatment of hilar cholangiocarcinoma in recent years were reviewed. Hilar cholangiocarcinoma is not clinically specific, hilar cholangiocarcinoma underwent high choledochojejunostomy Roux-en-Y anastomosis, unresectable palliative treatment or internal drainage, external drainage. Results Of the 12 patients, radical resection was performed in 9 cases, palliative resection in 2 cases (drainage in the biliary and intestine), extensive metastasis in 1 case due to tumor, occlusion of the hepatic portal and soft tissue in only 1 cm in the middle common bile duct. External drainage tube. Conclusion Hilar cholangiocarcinoma surgical treatment is the main means. Radical excision of the principle is: two cut ends without cancer residues, no metastasis in the liver, no lymph node metastasis. The correct evaluation of resectability before surgery, select the correct surgical procedure is the key to better prognosis.