摘要
目的探讨肝胆管结石合并胆管癌的临床特征和诊治要点。方法对 4 6例肝胆管结石合并胆管癌的临床资料进行回顾性研究。结果本组肝胆管结石合并胆管癌的发生率为 4 %(46 / 10 31) ;术前确诊率为 33% (15 / 4 6 ) ;术中病理检查确诊 18例 ,术后病理检查发现 6例。左肝胆管癌 72 % (33/ 4 6 ) ,右肝胆管癌 9% (4/ 4 6 ) ,肝门部胆管癌 2 0 % (9/ 4 6 )。肿瘤根治性切除率为 33%(15 / 4 6 )。姑息性手术 6 7% (31/ 4 6 )。有随访资料的 12例根治性切除术者 ,存活 1、2、3年者分别为12、8、3例。 12例胆管外引流者存活 2～ 7个月。结论胆石症病史 >10年 ,症状顽固者应进一步检查 ,及时手术。
Objective To study the clinical features, diagnosis,and treatment of hepatolithiasis complicated with cholangiocaminoma. MethodsClinical and pathological data were analysed retrospectively on 46 cases of hepatolithiasis complicated with cholangiocarcinoma. Results The results showed that the incidence of cholangiocarcinoma in hepatolithiasis was 4%, and 33% of patients were diagnosed as cholangiocarcinoma preoperatively. Tumor occurring in left intrahepatic ducts, right intrahepatic ducts, and hilar bile duct was 72%, 9% and 20%, respectively. Only 15(33%) cases underwent radical resection with 1-, 2-, and 3 year survival rate of 100%, 67% and 25% for the 12 cases that were closely followed-up. None of 15 cases receiving palliative bile duct drainage had survived for 1 year. KG2Conclusions Patients with a history of hepatolithiasis more than 10 years are under the risk of cholangiocarcinoma.During a surgery for hepatolithiasis a thorough exploration for the possible coexistance of cholangiocarcinoma is strongly recommended.
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第10期602-604,共3页
Chinese Journal of General Surgery
基金
福建省教育厅基金资助 (9A0 2 2 2 3 )
