Sugiura Y, Nakamura S, Iida S, Hosoda Y, Ikeuchi S, Mori S, Sugioka A, Tsuzuki T
Keio University School of Medicine, Japan.
Surgery. 1994 Apr;115(4):445-51.
It is necessary to elucidate whether extensive resection of the bile ducts combined with liver resection is a feasible and valid procedure for cancer of the main hepatic duct junction.
Based on a multi-institutional study, resectability rate, operative mortality, long-term survival, and factors contributory to long-term survival were investigated.
Between January 1973 and December 1991, a total of 158 patients with this cancer were admitted to Keio University Hospital and six affiliated institutions. Eighty-three (53%) of the 158 patients underwent resection, with seven (8.4%) postoperative deaths. The operations were performed by seven surgeons who were in charge of liver surgery at each respective institution. The 5-year actuarial survival rate of the 83 patients who underwent resection was 20%. Twelve patients survived more than 5 years, and these patients underwent curative resection. Three of the 12 patients were doing well after 10 years. Procedures of liver resection were right trisegmentectomy in two patients and left lobectomy with resection of the right portal vein in one.
It is clear that cancer of the main hepatic duct junction has become a curable disease. The operation is a valid procedure that can be widely practiced by competent surgeons.
有必要阐明广泛切除胆管并联合肝切除对于肝总管汇合部癌是否是一种可行且有效的手术方式。
基于一项多机构研究，对可切除率、手术死亡率、长期生存率以及影响长期生存的因素进行了调查。
1973年1月至1991年12月期间，共有158例该癌症患者入住庆应义塾大学医院及6家附属医院。158例患者中有83例（53%）接受了手术，术后死亡7例（8.4%）。手术由各机构负责肝脏手术的7名外科医生实施。83例接受手术的患者5年实际生存率为20%。12例患者存活超过5年，这些患者接受了根治性切除。12例患者中有3例在10年后情况良好。肝切除手术方式为2例患者行右三叶切除，1例患者行左叶切除并切除右门静脉。
显然，肝总管汇合部癌已成为一种可治愈的疾病。该手术是一种有效的手术方式，有能力的外科医生可广泛开展。
