Tsuzuki T, Uekusa M
Surg Gynecol Obstet. 1978 Jun;146(6):933-43.
The records of 31 patients with carcinoma of the proximal bile ducts were reviewed and the operative procedures, results, causes of deaths and autopsy findings were analyzed and correlated. Ten poor risk patients were treated by external drainage and died of jaundice or abscesses of the liver within six months. However, one patient survived 13 months after effective bilateral drainage. Twelve patients underwent intubation through the tumor into the hepatic ducts with or without postoperative irradiation. Four patients with irradiation survived 42, 15, 15 and ten months, while eight patients without irradiation died within six months. Autopsy findings of two patients who survived 15 months revealed metastases to the various organs. Four patients underwent resection. A patient who underwent resection of the common hepatic duct and hepaticoduodenostomy died of ascending cholangitis nine months postoperatively, while a patient treated by resection of the common hepatic duct with hepaticojejunostomy died of a recurrence 25 months postoperatively. Two patients underwent left hepatic lobectomy and resection of the right hepatic duct followed by hepatojejunostomy. One patient survived 25 months and died of a reccurrence, while the other patient died of abscesses of the liver ten months postoperatively.
回顾了31例肝门部胆管癌患者的病历，对手术方式、结果、死亡原因及尸检结果进行了分析并相互关联。10例高危患者接受了外引流治疗，在6个月内死于黄疸或肝脓肿。然而，1例患者在进行有效的双侧引流后存活了13个月。12例患者通过肿瘤插管进入肝管，部分患者术后接受了放疗。4例接受放疗的患者分别存活了42个月、15个月、15个月和10个月，而8例未接受放疗的患者在6个月内死亡。2例存活15个月的患者尸检发现有多处器官转移。4例患者接受了切除术。1例行肝总管切除及肝十二指肠吻合术的患者术后9个月死于上行性胆管炎，1例行肝总管切除及肝空肠吻合术的患者术后25个月死于复发。2例患者接受了左肝叶切除及右肝管切除，随后进行了肝空肠吻合术。1例患者存活25个月后死于复发，另1例患者术后10个月死于肝脓肿。
