Nakayama T, Shimada S, Kinoshita H, Kosuga K
2nd Dept. of Surgery, Kurume University School of Medicine.
Gan To Kagaku Ryoho. 1991 Jul;18(8):1264-8.
With the advances in various kinds of diagnostic methods and improvement of operative technique, operations for cancer in biliary tract have recently increased, however, the prognosis has been unsatisfied. During the past 25 years, 495 cases with carcinoma of biliary tract (ca of gall bladder 175 cases, ca of bile duct 201, and ca of papilla vater 105) were operated. The resectability rate was 66% (62% in gall bladder, 62% in bile duct, 84% in papilla vater). Among the lesions in bile duct, the resectable rate in lower bile duct was better than the other site in bile duct. The late results in ca of bile duct, especially in the lesion of upper bile duct were still poor, however, the 5-years survival rate in ca of gallbladder or papilla vater carcinoma was 61% or 56%, respectively. For the further improvement of the surgical results, the sufficient resection of the intrahepatic bile duct in ca of bile duct should be performed, and in gall bladder carcinoma when tumor extends into the neck of gall bladder, bile duct should be resected. In advanced carcinoma, the appropriate hepatectomy or bile duct resection should be considered in proportion to the operative influence and the extension of the tumor.
随着各种诊断方法的进步和手术技术的提高，近年来胆道癌手术有所增加，但预后仍不尽人意。在过去25年中，对495例胆道癌患者（胆囊癌175例、胆管癌201例、 Vater壶腹癌105例）进行了手术。切除率为66%（胆囊癌为62%、胆管癌为62%、Vater壶腹癌为84%）。在胆管病变中，胆管下段的可切除率优于胆管的其他部位。胆管癌的远期疗效，尤其是上段胆管病变的疗效仍然较差，然而，胆囊癌或Vater壶腹癌的5年生存率分别为61%和56%。为进一步提高手术效果，胆管癌应充分切除肝内胆管，胆囊癌肿瘤侵犯胆囊颈部时应切除胆管。在进展期癌中，应根据手术影响和肿瘤侵犯范围考虑适当的肝切除术或胆管切除术。
