Chen Xiao-ping, Huang Zhi-yong, Zhang Zhi-wei, Chen Yi-fa, Zhang Bi-xiang, Jiang Bin, Li En-shan
Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Wai Ke Za Zhi. 2009 Aug 1;47(15):1148-50.
To evaluate long-term outcomes of minor liver resection for hilar cholangiocarcinoma (HC) of Bismuth-Corlette type III.
From January 1997 to December 2007, the clinical data of 91 patients with Bismuth-Corlette type III HC underwent hepatectomy were collected and analyzed retrospectively.
There were 60 patients underwent minor hepatectomy, and 31 undergoing major hepatectomy. Hepaticojejunostomy was made conventionally in an end-to-side fashion in the patients undergoing major liver resection, and a new technique of hepaticojejunostomy used in the patients undergoing minor liver resection. That was the anterior edges of bile duct stumps which were not sutured after suturing of posterior edges. Instead of, the anterior edge of jejunum loop to the remnant liver on the top of the bile duct stumps were sutured with intermittent "U" sutures. In all patients, in-hospital mortality rate was 0 and rate of bile leakage was only 2.1%. The actual 1-, 3- and 5-year survival rates were 91.6% and 87.0%, 61.6% and 62.0%, 31.6% and 33.0%, respectively (P > 0.05).
Minor liver resection for the selected patients with HC of Bismuth-Corlette type III according to our criteria achieved better long-term outcomes. A new hepaticojejunostomy used in the patients undergoing minor liver resection is a safe and effective method.
评估针对Bismuth-Corlette III型肝门部胆管癌（HC）行小范围肝切除的长期疗效。
收集1997年1月至2007年12月期间91例行肝切除术的Bismuth-Corlette III型HC患者的临床资料并进行回顾性分析。
60例行小范围肝切除，31例行大范围肝切除。大范围肝切除患者常规行端侧方式的肝管空肠吻合术，小范围肝切除患者采用一种新的肝管空肠吻合技术。即后缘缝合后胆管残端前缘不缝合，而是将空肠袢前缘与胆管残端上方的残余肝脏用间断“U”形缝线缝合。所有患者住院死亡率为0，胆漏发生率仅为2.1%。实际1年、3年和5年生存率分别为91.6%和87.0%、61.6%和62.0%、31.6%和33.0%（P>0.05）。
根据我们的标准，对选定的Bismuth-Corlette III型HC患者行小范围肝切除可取得较好的长期疗效。小范围肝切除患者采用的新肝管空肠吻合术是一种安全有效的方法。
