摘要
作者报告自1989.12～1995.12月行肝门部胆管癌手术48例经验,全部病例就诊时均以黄疸为主要症状,术前经 B 超(48例)、CT(12例)、MRI(8例)等检查。明确诊断41例(85.4%)。48例均采用手术治疗。①肿瘤切除术19例(切除率39.6%),术后并发症11例(57.9%),死亡1例(5.3%),随访中位存活期18个月;②支撑管引流14例(29.2%),术后并发症7例(50%),死亡2例(14.3%),中位存活期11个月;③探查活检术15例(31.2%),术后并发症5例(33.3%),死亡2例(13.3%),术后3个月内全部死亡。作者认为肝门部胆管癌应力争手术切除以提高生存率。文中着重讨论了分型与手术方式的选择,介绍了提高切除率及手术安全性的经验。
From December of 1989 to December of 1995,48 patients with hilar cholangiocarcinoma were treated surgically in our department.At admission,the main symptom was obstructive jaundice in all patients,and the preoperative assessment of diagnosis has been made by ultrasound examination(48 cases), CT(12 cases),MRI(8 cases),and celiac and superior mesenteric arteriography(2 cases).Forty-one cases were diagnosed before operation by above examinations(85.4 %).Among them,19 cases had a resection of the hilar tumor(resection rate 39.6%).There were 11 patients having postoperative complications (57.9%)and 1 patient died(5.3%).The median survival time was 18 months.Fourteen patients (29.2 %)had intubation and drainage as a palliative treatmnet.Among them postoparative complications occurred in 7 cases(50.0%)and death in 2 after operation(14.3%).The median survival time was 11 months.In fifteen cases(31.2 %)subjected to exploration and biopsy,complications occurred in 5 cases (33.3 %)and death in 2(13.3 %).All of the rest 13 patients died during 3 months postoperatively.The authors conclude that surgical resection offers the best possibility of prolonged survival.The clinical classifi- cation,diagnostic criteria and the procedure of the operation are also discussed.
出处
《中华肝胆外科杂志》
CAS
CSCD
1998年第1期27-29,共3页
Chinese Journal of Hepatobiliary Surgery
