Cai Shou-wang, Duan Wei-dong, Liu Zhe, Zhao Xiang-qian, Zhang Wen-zhi, Wang Jing, Huang Xiao-qiang, Dong Jia-hong, Huang Zhi-qiang
Department of Hepatobiliary Surgery, General Hospital of People's Liberation Army, Beijing 100853, China.
Zhonghua Wai Ke Za Zhi. 2009 Aug 1;47(15):1138-41.
To summarize the methods, safety and efficiency of surgical resection for hilar cholangiocarcinoma.
The clinical and follow-up data of 48 patients with hilar cholangiocarcinoma underwent surgical resection from January 2003 to December 2007 were analyzed retrospectively. There were 26 male and 22 female, aged from 38 to 72 years old with a mean of 63.6 years old.
Perioperative management including percutaneous transhepatic biliary drainage applied in 19 cases and portal vein embolization applied in 2 cases. Eight patients were treated with extrahepatic bile duct resection with or without parital hepatic segment II resection, 10 cases with perihilar hepatic resection (segment IVB, partial V, partial VIII, I), 28 cases with extended hemihepatectomy and 2 cases with central hepatic resection (segment IVB, V, VIII, I). R0 resection rate was 89.5% and the operative mortality was 2.1%. The 1-, 3- and 5-year survival rate were 93.5%, 51.8% and 36.5%, respectively. Patients undergoing extended hepatic resection survived significantly longer than those undergoing partial hepatic resection (P = 0.034).
Extended hepatic resection for hilar cholangiocarcinoma offers good outcomes with an acceptable mortality rate.
总结肝门部胆管癌手术切除的方法、安全性及疗效。
回顾性分析2003年1月至2007年12月期间接受手术切除的48例肝门部胆管癌患者的临床及随访资料。其中男性26例，女性22例，年龄38至72岁，平均63.6岁。
围手术期处理包括19例行经皮肝穿刺胆道引流，2例行门静脉栓塞。8例患者行肝外胆管切除，可伴或不伴肝Ⅱ段部分切除；10例行肝门周围肝切除（Ⅳb段、Ⅴ段部分、Ⅷ段部分、Ⅰ段）；28例行扩大半肝切除；2例行肝中央切除（Ⅳb段、Ⅴ段、Ⅷ段、Ⅰ段）。R0切除率为89.5%，手术死亡率为2.1%。1年、3年和5年生存率分别为93.5%、
