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目的探讨肝门部胆管癌的诊断方法和外科治疗的疗效。方法回顾性分析1999年9月至2006年9月肝门部胆管癌手术治疗162例临床资料及随访结果。结果应用MR多种显像技术对肝门部胆管癌的定位及定性诊断率100%(86/86)。162例行手术治疗,其中探查术12例,内、外引流术56例,均于术后2~15个月死亡。切除术94例,手术切除率为58%(94/162),行根治性切除62例(17例联合肝动脉重建),中位生存期为29个月,姑息性切除32例,中位生存期为12个月。结论应用MR多种显像技术对肝门部胆管癌的定位及定性诊断率高,能较准确地评价肝门部胆管细胞癌的手术可切除性。根治切除是改善肝门部胆管癌疗效的重要措施;肝动脉重建可以减少术后并发症的发生。
Objective To investigate the diagnosis of hilar cholangiocarcinoma and the effect of surgical treatment. Methods The clinical data and follow-up results of 162 cases of hilar cholangiocarcinoma treated from September 1999 to September 2006 were retrospectively analyzed. Results The localization and qualitative diagnosis of hilar cholangiocarcinoma using MR imaging technique was 100% (86/86). 162 cases underwent surgical treatment, of which 12 cases of exploration, internal and external drainage of 56 cases, were 2 to 15 months after the death. The resection was done in 94 cases, the rate of resection was 58% (94/162), radical resection in 62 cases (17 cases of combined hepatic artery reconstruction), the median survival was 29 months, palliative resection in 32 cases, median survival The period is 12 months. Conclusions The MR imaging technique has the advantages of high localization and qualitative diagnosis of hilar cholangiocarcinoma. It can accurately evaluate the resectability of hilar cholangiocarcinoma. Radical resection is to improve the efficacy of hilar cholangiocarcinoma important measures; hepatic artery reconstruction can reduce the incidence of postoperative complications.