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[目的]探讨肝内胆管癌的临床特点、诊治和预后,以进一步提高其诊治水平。[方法]回顾性分析1993年12月至2009年8月经病理证实的肝内胆管癌23例患者临床资料,其中19例经开腹手术,包括单纯肝脏活检术7例,姑息性手术9例,根治性切除术3例,另4例经影像学定位下经皮肝脏穿刺活检。[结果]全组临床表现无特异性,合并肝内胆管结石或有肝内胆管结石手术史者47.9%(11/23),伴肝硬化者8.7%(2/23),血清CA19-9明显升高者52.2%(12/23),B超、CT诊断符合率分别为39.1%(9/23)、81%(17/21)。保守或姑息手术治疗者1年生存率15%(3/20),3例行根治性手术者1年生存率100%(3/3)。[结论]肝内胆管癌无特异性临床表现,根治性手术可明显延长其生存期。
[Objective] To investigate the clinical features, diagnosis, treatment and prognosis of intrahepatic cholangiocarcinoma to further improve the diagnosis and treatment of intrahepatic cholangiocarcinoma. [Methods] The clinical data of 23 patients with pathologically confirmed intrahepatic cholangiocarcinoma from December 1993 to August 2009 were retrospectively analyzed. Among them, 19 cases underwent laparotomy including 7 cases of simple liver biopsy, 9 cases of palliative surgery, Radical resection in 3 cases, and the other 4 cases by imaging location percutaneous liver biopsy. [Results] The clinical manifestations of the whole group were nonspecific. 47.9% (11/23) had history of intrahepatic bile duct stones or intrahepatic bile duct stones, 8.7% (2/23) had cirrhosis, and serum CA19-9 was obviously 52.2% (12/23), B ultrasound, CT diagnostic accuracy rates were 39.1% (9/23), 81% (17/21) respectively. One-year survival rates were 15% (3/20) for conservative or palliative surgeries, and 100% (3/3) for 3 surgical patients. [Conclusion] There is no specific clinical manifestations of intrahepatic cholangiocarcinoma, radical surgery can significantly prolong its survival.