军事医学2012，Vol.36Issue(1)：60-64,80,6.
49例肝门部胆管癌的手术治疗分析
Surgical treatment for hilar cholangiocarcinoma:analysis of 49 cases
金昌国 1张利刚 2欧阳才国 2董家鸿3
作者信息
- 1. 中国人民解放军军医进修学院,北京,100853
- 2. 航天中心医院肝胆外科,北京,100049
- 3. 中国人民解放军总医院肝胆外科,北京,100853
- 折叠
摘要
Abstract
Objective To assess the therapeutic strategies and prognostic factors that could influence the clinical outcome of hilar cholangiocarcinoma( HCC ). Methods A retrospective study was conducted on 49 cases of HCC, from June 2000 to May 2010 in Aerospace Central Hospital,who were divided into bile duct resection group( BD-group ),minor hepa-tectomy group( MiH-group ) and major hepatectomy group( MaH-group ). The complications after surgery were analyzed. Clinico-pathological data were analyzed by uni- and multivariate analyses to examine factors affecting the survival. Results There were 17 cases in BD-group, 10 cases in MiH-group and 22 cases in MaH-group. The morbidity rate of each group was 23. 5%( 4/17 ), 30%( 3/10 )and 72. 7%( 16/22 ),respectively. The total 1-, 3- and 5-year cumulative survival rate was 73. 2% ,41. 4% and 21. 3% ,and the median survival time was 30 months. The results from univariate analyses suggest that surgery, margin involvement, lymph node metastasis and T staging be significant predictors for survival rates. By multivariate analysis, only the lymph node metastasis( RR =3. 787 , 95% CI 0. 069 -25. 912 ) and margin involvement ( RR = 2. 447,95% CI 1. 508 - 3. 971 ) were significantly associated with poor survival rates. Conclusion Choosing an appropriate surgical approach for HCC according to T staging and lymph node metastasis can achieve a better short-term and longterm outcome.关键词
胆管肿瘤/术后并发症/肝切除术/危险因素/预后Key words
bile duct neoplasms/ postoperative complications/ hepatectomy/ risk factors/ prognosis分类
医药卫生引用本文复制引用
金昌国,张利刚,欧阳才国,董家鸿..49例肝门部胆管癌的手术治疗分析[J].军事医学,2012,36(1):60-64,80,6.
