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目的探讨联合肝叶部分切除在肝门部胆管癌根治术中的应用价值。方法对 42例行手术治疗的肝门部胆管癌患者的临床资料进行回顾性分析。结果42例患者中有34例行肿瘤切除术,其中局部切除15例,右半肝切除8例,左半肝切除3例,左半肝切除联合尾叶切除4例, 左肝外叶切除联合尾叶切除1例,方叶切除3例,总体手术切除率为81％。其中25例根治性切除,包括8例局部切除,及17例联合肝叶部分切除,根治性切除率为60％。根治性切除组的中位生存期 28个月,姑息性手术组的中位生存期14个月,根治性切除术的1年生存率为90%,2年生存率73％, 4年生存率28％,姑息性手术1年生存率为57％,2年生存率27％。结论根治性切除的生存率比姑息性手术显著提高,联合肝叶部分切除能明显提高根治性手术的切除率。
Objective To investigate the value of partial hepatectomy in the radical hilar cholangiocarcinoma. Methods The clinical data of 42 patients with hilar cholangiocarcinoma undergoing surgical treatment were retrospectively analyzed. Results Of the 42 patients, 34 had undergone tumor resection, including 15 cases of partial resection, 8 cases of right hepatectomy, 3 cases of left hepatectomy, 4 cases of left hepatectomy and caudate lobectomy, Caudate lobe resection in 1 case, 3 cases of square lobectomy, the overall surgical resection rate was 81%. Among them, 25 cases underwent radical resection, including 8 cases of partial resection and 17 cases of partial hepatectomy. The radical resection rate was 60%. The median survival was 28 months in the radical resection group, 14 months in the palliative surgery group, 90% in the one-year radical resection, 73% in 2-year survival, and 4-year survival 28%, palliative surgery 1-year survival rate was 57%, 2-year survival rate of 27%. Conclusions The survival rate of radical resection is significantly higher than that of palliative surgery. The resection combined with partial hepatectomy can obviously improve the resection rate of radical surgery.