• 孝感市中心醫(yī)院肝膽外科（湖北孝感 432100）;

目的  探討肝門部膽管癌2種手術(shù)方法的療效。方法  回顧性分析我院1998～2006年期間收治的37例肝門部膽管癌患者的臨床資料。結(jié)果  37例患者中13例行根治性手術(shù)切除, 其1年與3年的生存率分別為100%（13/13）和76.92%（10/13），中位生存期為22.43個(gè)月； 另24例行姑息性手術(shù)（均為肝內(nèi)膽管內(nèi)引流術(shù)），其1年與3年生存率分別為54.55%（12/22）和9.09%（2/22），中位生存期為15.42個(gè)月。結(jié)論  根治性手術(shù)是治療肝門部膽管癌的主要手段； 姑息性手術(shù)，如合理的肝內(nèi)膽管內(nèi)引流能改善患者的生存質(zhì)量。

引用本文： 胡超華,胡若男,熊杰,胡少輝,沈雄山,李衛(wèi)民,樊立. 肝門部膽管癌的手術(shù)治療. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009, 16(11): 873-874. doi: 復(fù)制

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1. 劉永鋒. 肝門部膽管癌的治療現(xiàn)狀 [Ｊ]. 中國(guó)實(shí)用外科雜志, 2000; 20(1): 28-31.
2. Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma [Ｊ]. Ann Surg, 1992; 215(1): 31-38.
3. 何效東, 董家鴻, 趙曉雷, 等. 肝門部膽管癌的診斷與外科治療 [Ｊ]. 中華肝膽外科雜志, 2008; 14(8): 582-584.
4. 秦錫虎, 朱峰, 段云飛, 等. 圍肝門膽道手術(shù)方式方法的探討附79例報(bào)告 [Ｊ]. 中華普外科手術(shù)學(xué)雜志(電子版), 2008; 2(3): 284-288.
5. Clary B, Jarnigan W, Pitt H, et al. Hilar cholangiocarcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(3): 298-302.
6. 梁力建. 重視肝門部膽管癌的診斷和治療 [Ｊ]. 中國(guó)實(shí)用外科雜志, 2007; 27(5): 351-353.
7. 黃志強(qiáng), 黃曉強(qiáng)主編. 肝膽胰外科聚焦 [M]. 第1版. 北京: 人民軍醫(yī)出版社, 2005: 338-350.
8. Capussotti L, Muratore A, Polastri R, et al ，Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival [Ｊ]. J Am Coll Surg, 2002; 195(5): 641-647.
9. Tsao JI, Nimura Y, Kamiya J, et al. Management of hilar cholangiocarcinoma: comparison of an American and a Japanese experience [Ｊ]. Ann Surg, 2000; 232(2): 166-174.
10. Jarnagin WR, Fong Y, DeMatteo RP, et al. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma [Ｊ]. Ann Surg, 2001; 234(4): 507-517; discussion 517-519.
11. 姜洪池， 陸朝陽(yáng). 肝門部膽管癌聯(lián)合尾狀葉根治性切除 [Ｊ]. 中國(guó)實(shí)用外科雜志, 2007; 27（5）： 364-366.
12. 黃志強(qiáng). 肝門部膽管癌外科治療的現(xiàn)狀與展望 [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(4): 317-320.
13. Kitagawa Y, Nagino M, Kamiya J, et al，Lymph node metastasis from hilar cholangiocarcinoma: audit of 110 patients who underwent regional and paraaortic node dissection [Ｊ]. Ann Surg, 2001; 233(3): 385-392.
14. Burke EC, Jarnagin WR, Hochwald SN, et al. Hilar Cholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system [Ｊ]. Ann Surg, 1998; 228(3): 385-394.
15. 彭淑牖, 李江濤. 肝門部膽管癌的術(shù)式選擇 [Ｊ]. 臨床外科雜志, 2006; 14(2): 70-72.
16. Ebata T, Nagino M, Kamiya J, et al. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases [Ｊ]. Ann Surg, 2003; 238(5): 720-727.
17. Kondo S, Nimura Y, Hayakawa N, et al. Extensive surgery for carcinoma of the gallbladder [Ｊ]. Br J Surg, 2002; 89(2): 179-184.
18. 周寧新, 黃志強(qiáng), 張文智, 等. 402例肝門部膽管癌臨床分型、手術(shù)方式與遠(yuǎn)期療效的綜合分析 [Ｊ]. 中華外科雜志, 2006; 44(23): 1599-1603.
19. 周寧新. 肝門部膽管癌擴(kuò)大根治術(shù)及療效評(píng)價(jià) [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(4): 323-324.
20. Inoue K, Makuuchi M, Takayama T, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma [Ｊ] . Surgery, 2000; 127(5): 498-505.
21. Kawasaki S, Imamura H, Kobayashi A, et al. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization [Ｊ]. Ann Surg, 2003; 238(1): 84-92.
  1. 1. 劉永鋒. 肝門部膽管癌的治療現(xiàn)狀 [Ｊ]. 中國(guó)實(shí)用外科雜志, 2000; 20(1): 28-31.
  2. 2. Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma [Ｊ]. Ann Surg, 1992; 215(1): 31-38.
  3. 3. 何效東, 董家鴻, 趙曉雷, 等. 肝門部膽管癌的診斷與外科治療 [Ｊ]. 中華肝膽外科雜志, 2008; 14(8): 582-584.
  4. 4. 秦錫虎, 朱峰, 段云飛, 等. 圍肝門膽道手術(shù)方式方法的探討附79例報(bào)告 [Ｊ]. 中華普外科手術(shù)學(xué)雜志(電子版), 2008; 2(3): 284-288.
  5. 5. Clary B, Jarnigan W, Pitt H, et al. Hilar cholangiocarcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(3): 298-302.
  6. 6. 梁力建. 重視肝門部膽管癌的診斷和治療 [Ｊ]. 中國(guó)實(shí)用外科雜志, 2007; 27(5): 351-353.
  7. 7. 黃志強(qiáng), 黃曉強(qiáng)主編. 肝膽胰外科聚焦 [M]. 第1版. 北京: 人民軍醫(yī)出版社, 2005: 338-350.
  8. 8. Capussotti L, Muratore A, Polastri R, et al ，Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival [Ｊ]. J Am Coll Surg, 2002; 195(5): 641-647.
  9. 9. Tsao JI, Nimura Y, Kamiya J, et al. Management of hilar cholangiocarcinoma: comparison of an American and a Japanese experience [Ｊ]. Ann Surg, 2000; 232(2): 166-174.
  10. 10. Jarnagin WR, Fong Y, DeMatteo RP, et al. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma [Ｊ]. Ann Surg, 2001; 234(4): 507-517; discussion 517-519.
  11. 11. 姜洪池， 陸朝陽(yáng). 肝門部膽管癌聯(lián)合尾狀葉根治性切除 [Ｊ]. 中國(guó)實(shí)用外科雜志, 2007; 27（5）： 364-366.
  12. 12. 黃志強(qiáng). 肝門部膽管癌外科治療的現(xiàn)狀與展望 [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(4): 317-320.
  13. 13. Kitagawa Y, Nagino M, Kamiya J, et al，Lymph node metastasis from hilar cholangiocarcinoma: audit of 110 patients who underwent regional and paraaortic node dissection [Ｊ]. Ann Surg, 2001; 233(3): 385-392.
  14. 14. Burke EC, Jarnagin WR, Hochwald SN, et al. Hilar Cholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system [Ｊ]. Ann Surg, 1998; 228(3): 385-394.
  15. 15. 彭淑牖, 李江濤. 肝門部膽管癌的術(shù)式選擇 [Ｊ]. 臨床外科雜志, 2006; 14(2): 70-72.
  16. 16. Ebata T, Nagino M, Kamiya J, et al. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases [Ｊ]. Ann Surg, 2003; 238(5): 720-727.
  17. 17. Kondo S, Nimura Y, Hayakawa N, et al. Extensive surgery for carcinoma of the gallbladder [Ｊ]. Br J Surg, 2002; 89(2): 179-184.
  18. 18. 周寧新, 黃志強(qiáng), 張文智, 等. 402例肝門部膽管癌臨床分型、手術(shù)方式與遠(yuǎn)期療效的綜合分析 [Ｊ]. 中華外科雜志, 2006; 44(23): 1599-1603.
  19. 19. 周寧新. 肝門部膽管癌擴(kuò)大根治術(shù)及療效評(píng)價(jià) [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(4): 323-324.
  20. 20. Inoue K, Makuuchi M, Takayama T, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma [Ｊ] . Surgery, 2000; 127(5): 498-505.
  21. 21. Kawasaki S, Imamura H, Kobayashi A, et al. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization [Ｊ]. Ann Surg, 2003; 238(1): 84-92.