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目的探讨肝门部胆管癌的诊断方法与外科治疗效果。方法对1996年1月～2006年1月间我院收治的肝门部胆管癌56例的临床诊疗资料及随访结果进行回顾性总结分析。结果B超及磁共振(MR)对肝门部胆管癌56例的定位及定性诊断率分别为91.1%和100%。56例均行手术治疗,其中探查术5例,内、外引流术23例,均于术后2～15个月死亡;切除术28例,手术切除率50.0%;行根治性切除24例(3例联合肝动脉重建),中位生存期为29个月;姑息性切除4例,中位生存期为12个月。结论应用B超和MR等多种影像技术对肝门部胆管癌的定位及定性诊断符合率高,能较准确地评估肝门部胆管癌的手术切除可能性。根治切除是改善肝门部胆管癌疗效的重要措施。
Objective To investigate the diagnosis and surgical treatment of hilar cholangiocarcinoma. Methods Clinical data and follow-up results of 56 cases of hilar cholangiocarcinoma admitted to our hospital from January 1996 to January 2006 were retrospectively analyzed. Results The localization and qualitative diagnosis of hilar cholangiocarcinoma by B ultrasound and magnetic resonance imaging (MR) were 91.1% and 100% respectively. Fifty-six cases underwent surgery, including 5 cases of exploration and 23 cases of internal and external drainage, all of whom died 2 to 15 months after surgery. Excision was performed in 28 cases and the surgical resection rate was 50.0%. Radical resection was done in 24 cases 3 cases of combined hepatic artery reconstruction), the median survival was 29 months; palliative resection in 4 cases, the median survival was 12 months. Conclusions The accuracy and accuracy of localization and qualitative diagnosis of hilar cholangiocarcinoma using B-mode ultrasonography and MR imaging can accurately assess the possibility of surgical removal of hilar cholangiocarcinoma. Radical resection is to improve the efficacy of hilar cholangiocarcinoma important measures.