摘要
目的 :研究分析 134例肝门部胆管癌临床诊治及远期疗效 ,探讨生存率与手术方式的关系及如何提高早期诊断率。方法 :分析解放军总医院肝胆外科 1999年 1月至 2 0 0 2年 7月收治的肝门部胆管癌 134例。结果 :手术组 116例 ,其中根治性切除 4 8例 ,姑息性切除 2 1例 ,胆道引流 4 7例 ;非手术组 18例。总手术率 86 .6 %( 116 / 134) ,根治性切除率 4 1.2 % ( 4 8/ 116 )。根治性切除组 1,2 ,3年生存率分别为 75 .0 %、4 5 .8%、2 5 .0 % ,姑息性切除组为 5 0 %、16 .7%、0 ,两组之间的生存率比较有显著性差异 (P <0 .0 5 ) ;胆道引流组为 2 5 %、10 %、0 ;非手术组平均存活 5 .7个月 ,无一例超过 1年。结论 :肝门部胆管癌的治疗以手术为主 ,个体化和实用性的根治性切除术才能获得最佳疗效。对无黄疸性慢性肝病及胃肠道症状者定期体检及必要的影象学检查 ,是早期发现肝胆管癌的积极手段 。
Objective:To strive to standardize the radical resection of hilar cholangiocarinoma,and have better curative effects as well as better survivals. Methods:A retrospective analysis was performed in 134 patients from 1999 to 2002,of whom 48 cases had received radical resection of hilar cholangiocarcinoma. Results:Of the 134 patients,69 under resection (radical resection in 48;palliative in 21),47 subjected to internal or external drainage and 18 only laparotomy. The total excision rate and the radical resection rate was 86.6%(116/134)and 41.2%(48/116), the survival of the radical resection was88.6%(39/44). The 1,2,3-year survival rate was 75.0%、45.8%、25.0% in radical resection group,and 50%、16.7%、0 in palliative resection group respectively,there is a remarkable difference between them. Whereas in unresectional internal and external drainage group,the 1,2,3-year survival rate was 25%、 10%、 0,All the patients with only laparotomy died within one year. Conclusion:The main treatment of hilar cholangiocarinoma is operation,and radical resection plays an important role for curative effect and long term survival rate in patients with H-CC.
出处
《军医进修学院学报》
CAS
2004年第3期169-171,共3页
Academic Journal of Pla Postgraduate Medical School
