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目的探讨20年来肝门部胆管癌切除率的变化,并分析其变化的因素。方法按不同年份对64例行手术治疗并经病理证实的肝门部胆管癌患者的临床资料进行回顾性研究。1982年1月至1992年1月收治的22例患者无一例切除;1998年1月至2004年1月收治的42例患者中有34例行肿瘤切除,手术切除率为81%。结果1998年1月至2004年1月收治的中位生存期25个月,1年生存率为78.9%,2年生存率为47%,4年生存率为22.4%。1982年1月至1992年1月收治的22例患者的中位生存期6个月,1年生存率为25.0%。两组相比差异均有统计学意义。结论近10年来肝门部胆管癌的切除率有了极大的提高,而手术器械的改进和手术技术的进步是提高肝门部胆管癌切除率的主要因素。
Objective To investigate the changes of hilar cholangiocarcinoma resection rate in the past 20 years and to analyze its changing factors. Methods The clinical data of 64 patients with hilar cholangiocarcinoma who underwent surgical treatment and were confirmed by pathology were retrospectively studied in different years. Twenty-two patients admitted between January 1982 and January 1992 had no resection. Of the 42 patients who were treated between January 1998 and January 2004, 34 had tumor resection with a resection rate of 81%. Results The median survival time from January 1998 to January 2004 was 25 months. The 1-year survival rate was 78.9%, the 2-year survival rate was 47%, and the 4-year survival rate was 22.4%. Twenty-two patients admitted between January 1982 and January 1992 had a median survival of 6 months and a one-year survival of 25.0%. The differences between the two groups were statistically significant. Conclusion The resection rate of hilar cholangiocarcinoma has been greatly improved in the past 10 years. The improvement of surgical instruments and the improvement of operative techniques are the main factors to improve the resection rate of hilar cholangiocarcinoma.