肝门部胆管癌57例诊治探析.pdfVIP

摘 要 肝门部胆管癌57例诊治分析 研究生：彭赟杰 指导教师：邵英梅 教授 摘 要 目的：探讨肝门部胆管癌的治疗方法及其临床效果。方法： 回顾性分析2000 年1月至2008年12月57例肝门部胆管癌的临床资料。结果：彩超联合CT、MRI/MRCP 是肝门部胆管癌术前行临床分型与分期最重要的检查手段。57例肝门部胆管癌按 Bismuth-corlitte分型, Ⅰ型6例, Ⅱ型13例, Ⅲa型13例, Ⅲb型10例, Ⅳ型15例。根治手术 19例,姑息手术18例, 支架引流术20例。根治性切除率51.4%。根治手术组1, 3, 5年生 存率分别为72.2% , 33.3% , 11.1%。姑息手术组1, 3, 5年生存率分别为37.5% , 12.5% , 0% 。支架引流组1, 3, 5年生存率分别为11.8% , 0% , 0% 。根治手术组和姑息手术组生 存率差异有统计学意义( P 0. 05) 。结论：根治性切除是目前治疗肝门部胆管癌最 有效的方法。姑息性切除、胆道引流有助于改善患者生活质量,延长生存。 关键词： 肝门部胆管癌；手术；根治性切除；回顾性研究 —1— 新疆医科大学医学硕士学位论文 Diagnosis and Treatment of 57 patients with hilar cholangiocarcinoma Postgraduate: Peng Yunjie Supervisor: Shao Yingmei Department of Hepatobiliary Surgery,The first affiliated hospital of Xinjiang Medical University Abstract Objective : To summarize the experience of therapy of hilar cholangiocarcinoma. Methods : From January 2000 to December 2008,57 cases of hilar cholangiocarcinoma were analyzed ret rospectively. Results : In Bismuth-corlitte classification, 6 caseswere Ⅰ category, 13 Ⅱ category, 13 Ⅲa category, 10 Ⅲb category, 15 Ⅳ category. Of all the cases, 19 patients underwent rasical resection, 18 patients underwent palliative operation, 20 internal biliary drainage. radical resection rate was 51.4%.The 1-,3-and 5-years survival rate of radical group, palliative group and internal biliary drainage group were 72.2% , 33.3% , 11.1%; 37.5% ,12.5% , 0% and 11.8% , 0% , 0% respectively. Conclusions : The best prognosis can be achieved by radical excision for patient with