摘要
目的总结肝胆管结石合并胆管癌的诊治经验。方法回顾性分析46例肝胆管结石合并胆管癌患者的临床资料,其中18例行根治性手术,28例行姑息手术。结果病理诊断为胆管腺癌36例,粘液癌10例。姑息组中有3例仅行活检术,术后1月死于肝功能衰竭。术后发生胆瘘1例,肝断面胆漏2例,伤口感染5例,均经保守治愈,2例伤口裂开经二期缝合治愈。随访43例,根治组平均存活26(13～45)个月,姑息治疗组平均存活10(5～14)个月。根治组术后1、2、3年生存率分别为94.4%、55.6%、33.3%,姑息组术后1年生存率为39.3%,无二年生存。结论肝胆管结石反复炎性刺激可并发胆管癌,根治性切除可延长生存期,姑息手术可提高生存质量;提高肝胆管结石合并胆管癌疗效的关键是争取早期根治性治疗肝胆管结石。
Objective To summarize the experience of diagnosis and treatment of intrahepatic lithiasis concomitant with cholangiocarcinoma. Method 46 cases of intrahepatic hthiasis concomitant with cholangiocarcinoma were retrospectively reviewed with regard to clinical features. 18 cases undergoing radical surgery, whereas 28 cases undergoing palliative surgery. Result Pathological diagnosis were bile ductal adenocarcinoma in 36 cases and mucinous carcinoma in 10 cases. 3 cases undergoing simply biopsy and died of liver failure 1 month thereafter. Complication including bile fistula in 1 case, bile leakage from cutting face in 2 cases and incisiona infection in 5 cases, which were conservatively cured, 2 cases of wound dehiscence cured by secondary suture. Average survival time were 26 months in radical surgery group and 10 months in palliative surgery group in consist with the followup in 43 cases. The 1-,2-, and 3-year survival rate in radical surgery were 94. 4%, 55.6%, 33.3% respectively, and 1-year survival rate in palliative surgery group was 39.3%. Conclusion Cholangiocarcinoma can be complicated secondary to long-term inflammation from intrahepatic lithiasis, survival can be improved by radical surgery.
出处
《中国现代手术学杂志》
2006年第1期43-45,共3页
Chinese Journal of Modern Operative Surgery
关键词
胆结石
胆管肿瘤
cholelithiasis
bile duct neoplasms
