Han Feng, Zhou Jin-xue, Zhang Ling, Han You-zhi
Department of Hepatobiliary and Pancreatic Surgery, Henan Tumor Hospital, Zhengzhou 450003, China.
Zhonghua Wai Ke Za Zhi. 2007 Jun 1;45(11):763-5.
To summarize the clinical experience and the role of hepatectomy with portal vein resection and reconstruction hilar cholangiocarcinoma.
From 1998 to 2003, the clinical records of 118 cases with hilar cholangiocarcinoma were reviewed.
Of the 118 patients, 66 were performed palliative treatment; and 52 patients underwent radical resection, of which 47 patients, including 11 cases combined with portal vein resection and reconstruction, underwent hepatectomy. The rate of postoperation complication was 22.9% and 27.3% in hepatectomy with or without portal vein resection and reconstruction respectively. The 1, 3-year survival rate were 85.7%, 31.4% and 81.8%, 27.8% in hepatectomy with or without portal vein resection and reconstruction respectively (P > 0.05). Only 5 patients were alive more than 3 years (7.58%), and no patient with palliative treatment lived over 5 years.
Portal vain invasion is not the contraindication of resection for hilar cholangiocarcinoma. Hepatectomy with portal vein resection and reconstruction may raise the radical resection rate of hilar cholangiocarcinoma and improve the results of prognosis.
总结门静脉切除重建治疗肝门部胆管癌的临床经验及作用。
回顾1998年至2003年118例肝门部胆管癌患者的临床资料。
118例患者中，66例行姑息性治疗；52例行根治性切除，其中47例行肝切除术，包括11例联合门静脉切除重建。肝切除联合或不联合门静脉切除重建的术后并发症发生率分别为22.9%和27.3%。肝切除联合或不联合门静脉切除重建的1、3年生存率分别为85.7%、31.4%和81.8%、27.8%（P>0.05）。仅5例患者生存超过3年（7.58%），姑息性治疗患者无1例生存超过5年。
门静脉受侵不是肝门部胆管癌切除的禁忌证。门静脉切除重建的肝切除术可提高肝门部胆管癌的根治性切除率并改善预后。
