肝门胆管癌荟萃分析及外科治疗的分析-临床医学专业论文.docxVIP

IX IX surgery and to explore the prognostic factors of hilar cholangiocarcinoma. Methods A retrospective cohort study was investigated from Jan, 2002 to Dec, 2008. The data of 94 patients with hilar cholangiocarcinoma were collected. Log-rank test was used to compare postoperative surgical rate. There were 50 males and 44 females. The mean age of the patients was 66.0 ± 12.0 years. Among main present symptoms jaundice was 67.0% and abdominal pain 61.4%%. Results According to Bismuth-Corlette typing, there were type I in 2 patients（2.1%）, type II in 3 patients（3.2%）, type IIIa in 9 patients（9.6%）, type IIIb in 12 patients（12.8%）and type IV in 68 patients（72.3%）. Forty-one patients were treated by ERCP. Two patients were treated by PTCD. Six patients were treated by operative procedures for reducing janudice. Eight patients were treated by exploratory laparotomy. Among 35 patients treated by tumor tesection, the rate of radical resection was 60.0%（21/35）. The 1-yr, 3-yrs, 5-yrs survival rate in lesion resection population was 26%, 18%, 3%, which was significantly higher than that in nonoperative jaundice-reducing group（P = 0.0001 0.01）. In 25 patients with highly or moderately differentiated adenocarcinoma, the mean survival time was 21.9 months, which was significantly longer than 13.8 months in 13 patients with lowly differentiated adenocarcinoma group（χ2 = 7.7173，P 0.01）. Conclusions Radical resection could improve postoperative survival, and the pathological classification would be one of the prognostic factors. 【Key words】hilar cholangiocarcinoma，surgical treatment， Meta-analysis PAGE PAGE IV 上海交通大学 学位论文原创性声明 本人郑重声明：所呈交的学位论文，是本人在导师的指导下，独立 进行研究工作所取得的成果。除文中已经注明引用的内容外，本论文不 包含任何其他个人或集体已经发表或撰写过的作品成果。对本文的研究 做出重要贡献的个人和集体，均已在文中以明确方式标明。本人完全意 识到本声明的法律结果由本人承担。 学位论文作者签名： 日期： 年 月 日 上海交通大学 学位论文版权使用授权书 本学位论文作者完全了解学校有关保留、使用学位论文的规定，同 意学校保留并向国家有关部门或机构送交论文的复印件和电子版，允许 论文被查阅和借阅。本人授权上海交通大学可以将本学位论文的全部或 部分内容编入有关数据库进行检索，可以采用影印、缩印或扫描等复制 手段保存和汇编本学位论文。 保密□，在 年解密后适用本授权书。 本