Surgical Treatment of Hilar Cholangiocarcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

胡超華 , 胡若男 , 熊杰 , 胡少輝 , 沈雄山 , 李衛民 , 樊立

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Keywords：

膽管癌; 　外科治療; 姑息性手術; 根治性手術; 　療效

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目的探討肝門部膽管癌2種手術方法的療效。方法回顧性分析我院1998～2006年期間收治的37例肝門部膽管癌患者的臨床資料。結果 37例患者中13例行根治性手術切除, 其1年與3年的生存率分別為100%（13/13）和76.92%（10/13），中位生存期為22.43個月；另24例行姑息性手術（均為肝內膽管內引流術），其1年與3年生存率分別為54.55%（12/22）和9.09%（2/22），中位生存期為15.42個月。結論根治性手術是治療肝門部膽管癌的主要手段；姑息性手術，如合理的肝內膽管內引流能改善患者的生存質量。

Citation： 胡超華,胡若男,熊杰,胡少輝,沈雄山,李衛民,樊立. Surgical Treatment of Hilar Cholangiocarcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(11): 873-874. doi: Copy

1.	劉永鋒. 肝門部膽管癌的治療現狀 [Ｊ]. 中國實用外科雜志, 2000; 20(1): 28-31.
2.	Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma [Ｊ]. Ann Surg, 1992; 215(1): 31-38.
3.	何效東, 董家鴻, 趙曉雷, 等. 肝門部膽管癌的診斷與外科治療 [Ｊ]. 中華肝膽外科雜志, 2008; 14(8): 582-584.
4.	秦錫虎, 朱峰, 段云飛, 等. 圍肝門膽道手術方式方法的探討附79例報告 [Ｊ]. 中華普外科手術學雜志(電子版), 2008; 2(3): 284-288.
5.	Clary B, Jarnigan W, Pitt H, et al. Hilar cholangiocarcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(3): 298-302.
6.	梁力建. 重視肝門部膽管癌的診斷和治療 [Ｊ]. 中國實用外科雜志, 2007; 27(5): 351-353.
7.	黃志強, 黃曉強主編. 肝膽胰外科聚焦 [M]. 第1版. 北京: 人民軍醫出版社, 2005: 338-350.
8.	Capussotti L, Muratore A, Polastri R, et al ，Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival [Ｊ]. J Am Coll Surg, 2002; 195(5): 641-647.
9.	Tsao JI, Nimura Y, Kamiya J, et al. Management of hilar cholangiocarcinoma: comparison of an American and a Japanese experience [Ｊ]. Ann Surg, 2000; 232(2): 166-174.
10.	Jarnagin WR, Fong Y, DeMatteo RP, et al. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma [Ｊ]. Ann Surg, 2001; 234(4): 507-517; discussion 517-519.
11.	姜洪池，陸朝陽. 肝門部膽管癌聯合尾狀葉根治性切除 [Ｊ]. 中國實用外科雜志, 2007; 27（5）： 364-366.
12.	黃志強. 肝門部膽管癌外科治療的現狀與展望 [Ｊ]. 中國普外基礎與臨床雜志, 2005; 12(4): 317-320.
13.	Kitagawa Y, Nagino M, Kamiya J, et al，Lymph node metastasis from hilar cholangiocarcinoma: audit of 110 patients who underwent regional and paraaortic node dissection [Ｊ]. Ann Surg, 2001; 233(3): 385-392.
14.	Burke EC, Jarnagin WR, Hochwald SN, et al. Hilar Cholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system [Ｊ]. Ann Surg, 1998; 228(3): 385-394.
15.	彭淑牖, 李江濤. 肝門部膽管癌的術式選擇 [Ｊ]. 臨床外科雜志, 2006; 14(2): 70-72.
16.	Ebata T, Nagino M, Kamiya J, et al. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases [Ｊ]. Ann Surg, 2003; 238(5): 720-727.
17.	Kondo S, Nimura Y, Hayakawa N, et al. Extensive surgery for carcinoma of the gallbladder [Ｊ]. Br J Surg, 2002; 89(2): 179-184.
18.	周寧新, 黃志強, 張文智, 等. 402例肝門部膽管癌臨床分型、手術方式與遠期療效的綜合分析 [Ｊ]. 中華外科雜志, 2006; 44(23): 1599-1603.
19.	周寧新. 肝門部膽管癌擴大根治術及療效評價 [Ｊ]. 中國普外基礎與臨床雜志, 2005; 12(4): 323-324.
20.	Inoue K, Makuuchi M, Takayama T, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma [Ｊ] . Surgery, 2000; 127(5): 498-505.
21.	Kawasaki S, Imamura H, Kobayashi A, et al. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization [Ｊ]. Ann Surg, 2003; 238(1): 84-92.

1. 劉永鋒. 肝門部膽管癌的治療現狀 [Ｊ]. 中國實用外科雜志, 2000; 20(1): 28-31.
2. Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma [Ｊ]. Ann Surg, 1992; 215(1): 31-38.
3. 何效東, 董家鴻, 趙曉雷, 等. 肝門部膽管癌的診斷與外科治療 [Ｊ]. 中華肝膽外科雜志, 2008; 14(8): 582-584.
4. 秦錫虎, 朱峰, 段云飛, 等. 圍肝門膽道手術方式方法的探討附79例報告 [Ｊ]. 中華普外科手術學雜志(電子版), 2008; 2(3): 284-288.
5. Clary B, Jarnigan W, Pitt H, et al. Hilar cholangiocarcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(3): 298-302.
6. 梁力建. 重視肝門部膽管癌的診斷和治療 [Ｊ]. 中國實用外科雜志, 2007; 27(5): 351-353.
7. 黃志強, 黃曉強主編. 肝膽胰外科聚焦 [M]. 第1版. 北京: 人民軍醫出版社, 2005: 338-350.
8. Capussotti L, Muratore A, Polastri R, et al ，Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival [Ｊ]. J Am Coll Surg, 2002; 195(5): 641-647.
9. Tsao JI, Nimura Y, Kamiya J, et al. Management of hilar cholangiocarcinoma: comparison of an American and a Japanese experience [Ｊ]. Ann Surg, 2000; 232(2): 166-174.
10. Jarnagin WR, Fong Y, DeMatteo RP, et al. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma [Ｊ]. Ann Surg, 2001; 234(4): 507-517; discussion 517-519.
11. 姜洪池，陸朝陽. 肝門部膽管癌聯合尾狀葉根治性切除 [Ｊ]. 中國實用外科雜志, 2007; 27（5）： 364-366.
12. 黃志強. 肝門部膽管癌外科治療的現狀與展望 [Ｊ]. 中國普外基礎與臨床雜志, 2005; 12(4): 317-320.
13. Kitagawa Y, Nagino M, Kamiya J, et al，Lymph node metastasis from hilar cholangiocarcinoma: audit of 110 patients who underwent regional and paraaortic node dissection [Ｊ]. Ann Surg, 2001; 233(3): 385-392.
14. Burke EC, Jarnagin WR, Hochwald SN, et al. Hilar Cholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system [Ｊ]. Ann Surg, 1998; 228(3): 385-394.
15. 彭淑牖, 李江濤. 肝門部膽管癌的術式選擇 [Ｊ]. 臨床外科雜志, 2006; 14(2): 70-72.
16. Ebata T, Nagino M, Kamiya J, et al. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases [Ｊ]. Ann Surg, 2003; 238(5): 720-727.
17. Kondo S, Nimura Y, Hayakawa N, et al. Extensive surgery for carcinoma of the gallbladder [Ｊ]. Br J Surg, 2002; 89(2): 179-184.
18. 周寧新, 黃志強, 張文智, 等. 402例肝門部膽管癌臨床分型、手術方式與遠期療效的綜合分析 [Ｊ]. 中華外科雜志, 2006; 44(23): 1599-1603.
19. 周寧新. 肝門部膽管癌擴大根治術及療效評價 [Ｊ]. 中國普外基礎與臨床雜志, 2005; 12(4): 323-324.
20. Inoue K, Makuuchi M, Takayama T, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma [Ｊ] . Surgery, 2000; 127(5): 498-505.
21. Kawasaki S, Imamura H, Kobayashi A, et al. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization [Ｊ]. Ann Surg, 2003; 238(1): 84-92.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Surgical Treatment of Hilar Cholangiocarcinoma

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