Akwari O E, Kelly K A
Arch Surg. 1979 Jan;114(1):22-5. doi: 10.1001/archsurg.1979.01370250024004.
Thirty-eight patients with primary adenocarcinoma arising at the junction of the right, left, and common hepatic biliary ducts were seen at the Mayo Clinic, Rochester, Minn, between 1950 and 1976. Prompt and lasting relief of jaundice and cholangitis occurred in four patients undergoing resection of the tumor combined with left hepatic lobectomy, and their mean survival was 33 months. Relief of symptoms was only temporary in 26 patients treated with drainage of the biliary tree, and their mean survival was only ten months. Eight patients undergoing exploration only had no relief of symptoms, and none survived beyond four months. We conclude that resection of these tumors in selected patients gives good palliation and offers the chance of long-term cure. If resection is not possible, biliary decompression results in satisfactory palliation, whereas exploration only does not.
1950年至1976年间，明尼苏达州罗切斯特市梅奥诊所收治了38例原发于左右肝管及肝总管交界处的腺癌患者。4例行肿瘤切除联合左肝叶切除术的患者黄疸和胆管炎迅速且持久缓解，平均生存期为33个月。26例行胆管引流术治疗的患者症状仅得到暂时缓解，平均生存期仅10个月。8例仅接受探查的患者症状未缓解，无一例存活超过4个月。我们得出结论，在部分患者中切除这些肿瘤可实现良好的姑息治疗，并提供长期治愈的机会。若无法进行切除，胆管减压可带来满意的姑息治疗效果，而仅进行探查则不然。
