中国现代手术学杂志2012，Vol.16Issue(2)：93-95,3.
肝门空肠扣式吻合术治疗Ⅲ型和Ⅳ型肝门部胆管癌
Button-like Cholangiojejunostomy in the Treatment of Type Ⅲ and IV Hilar Cholangiocarcinoma
王建国 1叶春华 1杨乾1
作者信息
- 1. 湖南省湘潭市中心医院普外科,湘潭411100
- 折叠
摘要
Abstract
Objective To discuss the feasibility of the surgical technique with button-like cholangiojeju-nostomy in the treatment for type III or IV hilar cholangiocarcinoma. Methods The clinical outcomes and the short-term complications were analyzed retrospectively in 12 patients from January 2010 to June 2011 with advanced hilar cholangiocarcinoma treated with button-like cholangiojejunostomy. There were 7 cases of male and 5 cases of female with 39 to 78 years old. The main clinical features were jaundice, blunt upper abdominal pain, and etc. The serum total hilirubin elevated in all cases, and the direct bilirubin elevated in 10 cases. The detection of tumor markers showed elevated CA199 in 12 cases, elevated CEA in 7 cases and elevated CA125 in 4 cases. Intrahepatic bile duct dilatation and hilar space-occupying were obtained by the ultrasound and CT/MRCP. According to the Bismuth-Corlette classification, there were 3 of type IIIa, 3 of type IIIb and 6 of type IV- All the cases underwent resection of the hilar cholangiocarcinoma with Roux-en-Y button-like cholangiojejunostomy. Results The efficacy of biliary, drainage in 12 patients was 100%. 1 case suffered from the biliary leakage after Roux-en-Y cholangiojejunostomy. No death occurred in the period of perioperation. There were 3 cases died at the third, fifth and tenth months after operation respectively, and the others all survived. Conclusion A positive attitude should be kept to the surgical treatment for advanced hilar cholangiocarcinoma. It can increase the resection rate of the button-like cholangiojejunostomy for the type III and IV hilar bile duct carcinoma, and is recommended as a viable treatment method.
关键词
胆管肿瘤/吻合术,Roux-en-YKey words
bile duct neoplasms/ anastomosis,Roux-en-Y分类
医药卫生引用本文复制引用
王建国,叶春华,杨乾..肝门空肠扣式吻合术治疗Ⅲ型和Ⅳ型肝门部胆管癌[J].中国现代手术学杂志,2012,16(2):93-95,3.
