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目的对肝门胆管癌外科治疗疗效进行评价。方法回顾分析2007年3月-2012年3月收治的156例肝门胆管癌患者的临床资料。按手术方式将患者分为手术切除组(n=45)、胆道引流组(n=78)和姑息治疗组(n=33),并对住院期间并发症发生率、病死率及生存时间等进行分析。结果 156例患者根治性切率为23.1%不同治疗方式住院期间病死率差异无统计学意义(P<0.05);手术治疗组与姑息治疗组并发症发生率差异有统计学意义(P<0.05)。手术切除组、胆道引流组、姑息治疗组的1、3、5年累积生存率分别为64.4%、17.8%、0.0%;40.2%、12.6%、12.6%;17.7%、7.1%、0.0%,手术切除组生存情况明显好于其他两组(P<0.05)。结论不建议所有患者术前均引流可减黄,且可以不过分强调R0切除。胆道引流可一定程度改善预后,但近远期胆道感染相关并发症发生率较高。
Objective To evaluate the curative effect of surgical treatment of hilar cholangiocarcinoma. Methods The clinical data of 156 patients with hilar cholangiocarcinoma who were treated from March 2007 to March 2012 were retrospectively analyzed. The patients were divided into surgical resection group (n = 45), biliary drainage group (n = 78) and palliative treatment group (n = 33). The incidence of complications, mortality and survival time analysis. Results There was no significant difference in mortality rate between hospitalized patients and control group (P> 0.05). The incidence of complications in surgical treatment group and palliative treatment group was significantly different (P <0.05) . The 1, 3, 5-year cumulative survival rates of surgical resection group, biliary drainage group and palliative treatment group were 64.4%, 17.8%, 0.0%, 40.2%, 12.6%, 12.6%, 17.7%, 7.1%, 0.0% Survival of the surgical resection group was significantly better than the other two groups (P <0.05). Conclusion It is not recommended that all patients be drained before surgery to reduce the yellow, and can not overemphasis on R0 resection. Biliary drainage can improve the prognosis to a certain extent, but the incidence of biliary tract infection-related complications in the near future is higher.