中国普通外科杂志2011，Vol.20Issue(2)：114-118,5.
肝门部胆管癌患者的手术治疗
The surgical treatment of hilar cholangiocarcinoma patients
菅志远 1沈先锋 1周猛 1周平 1张敏 1兰明银1
作者信息
- 1. 湖北医药学院太和医院普外科Ⅰ科,湖北,十堰,442000
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摘要
Abstract
Objective To explore the related factors that can influence the prognosis of patients with resectable hilar cholangiocarcinoma. Methods The clinical data and survival status of 44 cases of resected hilar cholangiocarcinoma, in our department in the latest 6 years, were analyzed retrospectively by univariate and multivariate analysis. Results Of all the 44patients, the R0 , R1 and R2 resection was done in 38, 6 and 0 cases, respectively. A new technique of hepaticojejunostomy, in which the anterior edges of the jejunal end were sutured to the liver above the opening of bile duct stump after suturing of posterior edges, was used in 25 patients, and the traditional hepaticojejunostomy technique was used in the other 19 patients; the bile leakage rate of the former techniqne was significantly less than that of the latter (x2 =4. 565, P =0.033 ).The clinical stage, extent of liver resection whether or not R0 resecion was done and lymph nodes metastasis were the factors that affected the survival with statistical difference by univariate analysis ( P ＜ 0. 05 ); while the clinical stage and whether or not R0 resection was done were the independent prognosis factors that affected the survival by multivariate Cox regression analysis ( P ＜ 0. 05 ). Conclusions The clinical stage and attainment of R0 resecion are the key factors that affect the prognosis of patients with resectable hilar cholangiocarcinoma; the new technique of hepaticojejunostomy is a useful measure which can decrease the resection extent of normal liver tissue while making sure that the tumor is completely resected.关键词
胆管肿瘤/外科学/肝门部/胆管肠吻合术/预后分类
医药卫生引用本文复制引用
菅志远,沈先锋,周猛,周平,张敏,兰明银..肝门部胆管癌患者的手术治疗[J].中国普通外科杂志,2011,20(2):114-118,5.
