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目的总结肝门部胆管癌手术治疗的经验。方法回顾性分析本院9年因肝门部胆管癌行手术切除的83例病人的临床资料和随访结果。结果 83例手术切除病人中行根治性切除(R_0)31例,非根治切除52例(R_1,R_2).术后出现并发症29例,死亡5例。根治性切除组中位生存期21.5个月,1、3、5年生存率分别为79.6%,43.3%和25.9%.明显优于非根治性切除组(P<0.05)。近5年本院根治性切除率达44.8%,中位生存期18.7个月,疗效明显提高(P<0.05)。结论加强围手术期处理、术中行切缘冰冻病理检布、联合肝切除等可提高肝门部胆管癌根治性切除率、减少并发症和死亡率;根治性切除可更好延长病人生存期,使手术治疗肝门部胆管癌获得良好的疗效。
Objective To summarize the experience of surgical treatment of hilar cholangiocarcinoma. Methods The clinical data and follow-up results of 83 patients who underwent surgical resection for hilar cholangiocarcinoma in our hospital for 9 years were retrospectively analyzed. Results There were 31 cases of radical resection (R_0) and 52 cases of non-radical resection (R_1, R_2) in 83 cases of surgical resection. There were 29 cases of complications and 5 cases of death. In the radical resection group, the median survival time was 21.5 months, and the 1, 3, 5-year survival rates were 79.6%, 43.3% and 25.9%, respectively, which were significantly better than those of the non-radical resection group (P <0.05). In the past 5 years, the radical resection rate in our hospital was 44.8%, and the median survival time was 18.7 months. The curative effect was significantly improved (P <0.05). Conclusion To improve the perioperative management, intraoperative marginal edge frozen pathological detection, combined with hepatectomy can improve the hilar cholangiocarcinoma radical resection rate and reduce complications and mortality; radical resection can better extend the patient’s survival, Surgical treatment of hilar cholangiocarcinoma to obtain a good effect.