Mena F J, Velicia R, Valbuena M C, González J M, Caro-Patón A, Pérez-Miranda M, Bellido J
Department of Gastroenterology: "Rio Hortega" University Hospital, Vlladold, Spain.
Rev Esp Enferm Dig. 1999 Apr;91(4):297-304.
to analyze the epidemiology, prognosis and treatment of those diagnosed as having cholangiocarcinoma of the extrahepatic biliary tree.
a prospective study including all cases diagnosed over a period of 26 months. Fifteen patients with primary bile duct carcinoma were included.
the incidence rate was 3.23 cases/10(4). The tumor locations were: 40% proximal bile duct, 33% distal bile duct, and 27% mid-duct. The treatments used were: curative resection in 1 case (7%); palliative surgery in 3 cases (20%); internal drainage through a prosthetic biliary stent by endoscopic retrograde cholangiopancreatography in 6 cases (40%) and by percutaneous transhepatic cholangiography in 2 cases (13%); external bile drainage in case (7%), and in the remaining 2 patients (13%) no treatment was possible. The 1-month, 6-month and 10-month survival rates were 67%, 40% and 33% respectively. Factors associated with a worse survival in this study were age over 70 years and female sex. The worst prognostic location was the mid-duct compared to the distal and proximal thirds.
the incidence of the primary bile duct carcinoma is high in our population. The commonest location is the proximal bile duct. Curative surgical resection is possible in only a few cases, and thus the overall prognosis is very bad.
分析肝外胆管系统胆管癌患者的流行病学、预后及治疗情况。
一项前瞻性研究，纳入26个月期间确诊的所有病例。共纳入15例原发性胆管癌患者。
发病率为3.23例/10⁴。肿瘤部位分布为：近端胆管40%，远端胆管33%，中段胆管27%。治疗方式如下：根治性切除术1例（7%）；姑息性手术3例（20%）；经内镜逆行胰胆管造影放置胆道支架进行内引流6例（40%），经皮肝穿刺胆管造影放置胆道支架进行内引流2例（13%）；外引流1例（7%），其余2例患者（13%）无法进行治疗。1个月、6个月和10个月生存率分别为67%、40%和33%。本研究中与较差生存相关的因素为年龄超过70岁及女性。与远端和近端三分之一相比，预后最差的部位是中段胆管。
在我们的人群中，原发性胆管癌的发病率较高。最常见的部位是近端胆管。仅少数病例可行根治性手术切除，因此总体预后很差。
