CAJ | 학술논문

目的　探讨肝门部胆管癌的诊断及手术治疗方法。方法　回顾性分析73例肝门部胆管癌的临床特点、手术方法及治疗效果。结果　本组术前均明确诊断。B超诊断符合率为69.9%。根治性切除15例，近期效果良好；各种胆管内外引流术43例，37例获缓解，手术后死亡6例；剖腹探查或肝动脉插管化疗15例，术后短期内病情无变化。获根治性切除15例中，11例得到随访，1，3年生存率分别为90.9%，20.0%，无5年生存者。其他各种术式的生存时间无超过9个月者。结论　肝门部胆管癌早期诊断仍困难，联合应用影像学检查可明确诊断，B超为首选检查方法。目前根治性切除率仍较低，肝方叶切除对最后选定手术方式有一定帮助。
목적　탐토간문부담관암적진단급수술치료방법。방법　회고성분석73례간문부담관암적림상특점、수술방법급치료효과。결과　본조술전균명학진단。B초진단부합솔위69.9%。근치성절제15례，근기효과량호；각충담관내외인류술43례，37례획완해，수술후사망6례；부복탐사혹간동맥삽관화료15례，술후단기내병정무변화。획근치성절제15례중，11례득도수방，1，3년생존솔분별위90.9%，20.0%，무5년생존자。기타각충술식적생존시간무초과9개월자。결론　간문부담관암조기진단잉곤난，연합응용영상학검사가명학진단，B초위수선검사방법。목전근치성절제솔잉교저，간방협절제대최후선정수술방식유일정방조。
Objective　To evaluate the diagnosis and surgical treatment of hilar cholangiocarcinoma(H-CC). Methods　Retrospective analysis was made on the clinical feature, surgical treatment and the effect on 73 patients with H-CC. Results　Diagnosis was made in all of the patients preoperatively and the correct diagnostic rate of BUS was 69.9%. In the treatment, radical resection was performed on 15 patients with good results in a short-term period. Of the 43 patients who underwent biliary tract internal drainage or exterrnal drainage, 37 patients had good results in a short-term period, while 6 died after operation. Laparotomy or hepatic artery cannulization with chemotherapy was performed on 15 patients and no change occurred in a short-term period after operation. In 15 cases subjected to radical resection, 11 cases were followed up. The 1,3-year survival rates was 90.9%, 20.0% respectively, but none of the patients survived for over 5 years. In patients undergoing other operations, none survived more than 9 months. Conclusions　It's still difficult to mak early diagnosis of H-CC, which mainly depends on imaging technics. The BUS should be choiced first. Radical resection rate is still low nowadays. The lobus quadratus resection is helpful to select the operation.