Peng Shu-you, Wang Jian-wei, Liu Ying-bin, Cai Xiu-jun, Mou Yi-ping, Wu Yu-lian, Fang He-qing, Peng Cheng-hong
Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009 China.
Zhonghua Wai Ke Za Zhi. 2003 Mar;41(3):169-71.
To summarize the experience of surgical intervention for hepatocellular carcinoma (HCC) with bile duct thrombi (BDT), and to evaluate the influence on prognosis.
From 1994 to 2002, 15 patients with HCC and BDT who underwent surgical intervention were retrospectively analyzed.
The operative procedures included hepatectomy with removal of BDT (n = 7), hepatectomy combined with extrahepatic bile duct resection (n = 4), thrombectomy through choledochotomy (n = 3), and piggy-back orthotopic liver transplantation (n = 1). The 1- and 3-year survival rates were 73.3% and 40%, respectively. Two patients survived over 5 year. The survival rate of patients with portal vein invasion was significantly lower than that of patients without portal vein invasion (P < 0.05).
Surgical intervention was effective for patients with HCC and BDT. Operation after recurrence can prolong the survival time. Liver transplantation is a new operative procedure worthy of study.
总结肝细胞癌（HCC）合并胆管癌栓（BDT）的外科治疗经验，并评估其对预后的影响。
回顾性分析1994年至2002年期间接受手术治疗的15例HCC合并BDT患者的临床资料。
手术方式包括肝切除联合BDT取出术（7例）、肝切除联合肝外胆管切除术（4例）、胆总管切开取栓术（3例）和背驮式原位肝移植术（1例）。1年和3年生存率分别为73.3%和40%。2例患者生存超过5年。门静脉受侵患者的生存率显著低于未受侵患者（P<0.05）。
外科治疗对HCC合并BDT患者有效。复发后手术可延长生存时间。肝移植是一种值得研究的新手术方式。
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