Berchtold D, Sulser T, Akovbiantz A
Helv Chir Acta. 1989 Jun;56(1-2):183-7.
Based on a retrospective study concerning the years 1974 to 1987 93 malignant extrahepatic bile duct tumors are being analyzed with regard to its histology, therapy and time of survival. The cases referred to herein are 49 tumors of the gallbladder and 44 bile duct tumors (25 tumors of the hepatic confluation, 10 tumors of the middle and 9 tumors of the distal portion of the bile duct). The middle and the distal hepatic duct tumors with 15.1 and 14.5 months respectively from the beginning of therapy have the longest time of survival on average. In contrast to those figures there are the bifurcation tumors with 9.9 months and the gallbladder tumors with 6.1 months of survival. So far 3 patients (2 with a gallbladder and 1 with a middle hepatic duct tumor) have survived as long as 3 years and are still alive. Only 1 patient, relating to a time of survival of 5 years, has been cured (gallbladder). 26.5% of these patients needed a second, 9.5% of them a third operation. A lengthy resection with curative intentions was done on 20.4% of the patients. 76.3% were treated palliatively, preferring, whenever possible internal drainage methods such as endoprosthesis or direct anastomosis drainage (hepaticojejunostomy, hepaticoduodenostomy, etc.).
基于一项关于1974年至1987年的回顾性研究，对93例肝外恶性胆管肿瘤的组织学、治疗方法和生存时间进行了分析。本文提及的病例包括49例胆囊肿瘤和44例胆管肿瘤（25例肝门部肿瘤、10例中部肿瘤和9例胆管远端肿瘤）。肝门中部和远端胆管肿瘤从治疗开始起平均生存时间最长，分别为15.1个月和14.5个月。与之形成对比的是，肝门部肿瘤的生存时间为9.9个月，胆囊肿瘤的生存时间为6.1个月。到目前为止，有3例患者（2例胆囊肿瘤患者和1例肝门中部胆管肿瘤患者）存活了3年且仍在世。只有1例生存时间达5年的患者已治愈（胆囊肿瘤）。这些患者中有26.5%需要进行二次手术，9.5%需要进行三次手术。20.4%的患者接受了旨在治愈的广泛切除术。76.3%的患者接受了姑息治疗，尽可能优先采用内引流方法，如内置假体或直接吻合引流（肝空肠吻合术、肝十二指肠吻合术等）。
