论文部分内容阅读
目的本文探讨肝门部胆管癌的早期诊断方法,以提高手术切除率。方法回顾分析2005～2011年收治肝门部胆管癌30例的临床病例资料。结果术前确诊26/30(86.67%)。手术切除16例(53.33%),其中根治性切除(R0切除)10例(33.33%)、姑息性切除6例(20%),引流术12例(40%),单纯剖腹探查术2例(6.67%)。术后随访28例,2人失访,随访率92.86%(26/28),其中随访根治性切除10例,1、3、5年生存率分别为70%、50%、20%。随访姑息性切除6例,1、3年各1例,4例于一年内死亡。随访引流术10例全部于半年内死亡。结论肝门部胆管癌早期诊断困难,根治性切除率低,影像学检查可提高早期诊断率,对黄疸病人应尽早行影像学等相关检查,以提高根治切除率。手术是肝门部胆管癌的首选治疗。
Objective This article discusses the early diagnosis of hilar cholangiocarcinoma in order to improve the surgical resection rate. Methods The clinical data of 30 cases of hilar cholangiocarcinoma from 2005 to 2011 were retrospectively analyzed. Results The preoperative diagnosis was 26/30 (86.67%). There were 16 cases (53.33%) underwent surgical resection, including 10 cases (33.33%) underwent radical resection (R0 resection), 6 cases (20%) underwent palliative resection, 12 cases (40% 6.67%). Follow-up was performed in 28 cases and 2 patients were lost to follow-up. The follow-up rate was 92.86% (26/28). Of them, 10 cases were followed up for radical resection. The 1, 3 and 5-year survival rates were 70%, 50% and 20% respectively. Follow-up palliative resection in 6 cases, 1 and 3 years in 1 case, 4 cases died within a year. Follow-up drainage in 10 cases all died within six months. Conclusions Early diagnosis of hilar cholangiocarcinoma is difficult, and the radical resection rate is low. Radiographic examination can improve the early diagnosis rate, and the patients with jaundice should be examined as soon as possible to improve the radical resection rate. Surgery is the treatment of choice for hilar cholangiocarcinoma.