Zhao Hao-liang, Wei Zhi-gang, He Jie-feng, Liu Jian-sheng, Zhao Ying, Bao Min-sheng
Department of General Surgery, First Affiliated Hospital, Shanxi Medical University, Taiyuan 030001, China.
Zhonghua Wai Ke Za Zhi. 2009 Aug 1;47(15):1145-7.
To report the experience of surgical resection of Bismuth-Corlette type I and II hilar cholangiocarcinoma.
From January 1998 and January 2008, 52 cases of Bismuth-Corlette type I and II hilar cholangiocarcinoma were operated on. The clinical data and long-term outcome of the patients was retrospectively analyzed.
Of the 52 cases, 44 cases (84.6%) received operation, 28 patients underwent radical resection (63.6%) and 16 patients (36.4%) underwent palliative resection.Seven patients were resected on caudate lobe and other section and lobe of the liver; among them, 2 patients received combined portal vein resection and 4 underwent combined hepatic artery resection respectively. Eleven cases developed postoperative complications and another one died in hospital. The median survival was 33.2 months in radical resection group, and 1-, 3-, 5-year survival rate was 82.6%, 47.8%, 34.7%, respectively, which was significant greater than those in the palliative resection group (41.6%, 16.6%, 8.3%, respectively) (P < 0.05). The median survival was 16.7 months in the palliative resection group.
The radical resection is still the best treatment for Bismuth-Corlette type I and II hilar cholangiocarcinoma. Intraoperative pathology for resection margin, and combined liver resection, portal vein resection and hepatic artery resection can help improve the radical resection rate.
报告手术切除Bismuth-Corlette I型和II型肝门部胆管癌的经验。
1998年1月至2008年1月,对52例Bismuth-Corlette I型和II型肝门部胆管癌患者进行手术治疗。回顾性分析患者的临床资料及远期疗效。
52例患者中,44例(84.6%)接受了手术,28例患者(63.6%)行根治性切除,16例患者(36.4%)行姑息性切除。7例患者行尾状叶及肝脏其他段叶切除;其中2例患者分别接受联合门静脉切除,4例患者分别接受联合肝动脉切除。11例患者发生术后并发症,1例患者死于医院。根治性切除组的中位生存期为33.2个月,1年、3年、5年生存率分别为82.6%、47.8%、34.7%,显著高于姑息性切除组(分别为41.6%、16.6%、8.3%)(P<0.05)。姑息性切除组的中位生存期为16.7个月。
根治性切除仍是治疗Bismuth-Corlette I型和II型肝门部胆管癌的最佳方法。术中切缘病理检查,联合肝切除、门静脉切除和肝动脉切除有助于提高根治性切除率。