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93 例肝门部胆管癌的外科治疗及预后分析。

Surgical treatment and prognostic analysis of 93 cases of hilar cholangiocarcinoma.

机构信息

Second Department of General Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, China.

出版信息

Am J Med Sci. 2010 Mar;339(3):221-4. doi: 10.1097/MAJ.0b013e3181c7c8b4.

Abstract

OBJECTIVE

To explore the surgical treatment and prognosis of hilar cholangiocarcinoma.

METHODS

This was a retrospective study of 93 cases of hilar cholangiocarcinoma that were treated surgically at our hospital from June 1999 to June 2005. Prognostic factors were also analyzed.

RESULTS

Fifty-two cases were treated with curative resection, 21 with palliative resection, and 9 with nonoperative drainage. Eleven cases underwent palliative drainage operations. The median survive time was 31 months in the curative resection group, 13.7 months in the palliative resection group, and 11 months in the nonoperative drainage group. Patient age, serum total bilirubin, clinical type of Bismuth-Corlette, tumor differentiation, and lymph node metastases were important factors for predicting the prognosis of hilar cholangiocarcinoma.

CONCLUSIONS

Resection was the main treatment for hilar cholangiocarcinoma, and curative resection was the best way to obtain better prognosis. Age, preoperative serum total bilirubin, bismuth clinical type, tumor histopathological grading, and lymph node metastases were considered to have a significant effect on prognosis.

摘要

目的

探讨肝门部胆管癌的外科治疗及预后。

方法

回顾性分析我院 1999 年 6 月至 2005 年 6 月 93 例肝门部胆管癌的外科治疗资料,分析影响预后的因素。

结果

根治性切除 52 例,姑息性切除 21 例,非手术引流 9 例,姑息性内引流 11 例。根治性切除、姑息性切除及非手术引流组的中位生存时间分别为 31 个月、13.7 个月及 11 个月。患者年龄、术前血清总胆红素、Bismuth-Corlette 临床分型、肿瘤分化程度及淋巴结转移是影响肝门部胆管癌预后的重要因素。

结论

手术切除是肝门部胆管癌的主要治疗方法,根治性切除是获得较好预后的最佳手段。年龄、术前血清总胆红素、Bismuth-Corlette 临床分型、肿瘤组织学分级及淋巴结转移是影响预后的重要因素。

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