Sun Yi, Wu Zhi-Yu, Hao Chun-Yi, Huang Xin-Fu, Wang Kun, Bao Quan, Qian Hong-Gang, Xing Bao-Cai
Department of Surgery, Peking University School of Oncology, Beijing Cancer Hospital, Beijing, China.
Zhonghua Yi Xue Za Zhi. 2008 Feb 26;88(8):527-30.
To investigate the superiority of curative resection with hemihepatectomy in treatment of hilar cholangiocarcinoma and the strategy to lower the incidence of complications and mortality.
The clinical data of 50 patients with hilar cholangiocarcinoma who underwent surgical procedures in Peking University School of Oncology from January 1998 to May 2006 were retrospectively analyzed.
Forty-one patients (56.9%) underwent surgical resection. Twenty-two (53.6%) received a radical operation (RO). Thirty patients underwent preoperative percutaneous transhepatic cholangio-drainage (PTCD) to reduce the jaundice. Curative resection with hemihepatectomy was performed on 19 cases including 14 cases undergoing RO. Two patients who had undergone hemihepatectomy died of liver failure. The postoperative morbidity rate was 62% in all 50 cases, 78% in the hemihepatectomy group. The 1- and 2-year survival rates of the hemihepatectomy group were 57.1% and 27.3% respectively.
Curative resection with hemihepatectomy is a safe and effective option for hilar cholangiocarcinoma, especially for Bismuth III or IV type. Preoperative biliary drainage is necessary before a major hepatic resection.
探讨半肝切除根治性切除术治疗肝门部胆管癌的优势以及降低并发症发生率和死亡率的策略。
回顾性分析1998年1月至2006年5月在北京大学肿瘤医院接受手术治疗的50例肝门部胆管癌患者的临床资料。
41例（56.9%）患者接受了手术切除。22例（53.6%）接受了根治性手术（RO）。30例患者术前行经皮经肝胆管引流术（PTCD）以减轻黄疸。19例行半肝切除根治性切除术，其中14例行RO。2例行半肝切除术的患者死于肝衰竭。50例患者术后总并发症发生率为62%，半肝切除组为78%。半肝切除组1年和2年生存率分别为57.1%和27.3%。
半肝切除根治性切除术治疗肝门部胆管癌是一种安全有效的选择，尤其适用于Bismuth III或IV型。在进行大范围肝切除术前，术前胆道引流是必要的。
