中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2001年
2期
109-111
,共3页
赵建勋%乔岐禄%孙占祺%万远廉%黄莚庭
趙建勛%喬岐祿%孫佔祺%萬遠廉%黃莚庭
조건훈%교기록%손점기%만원렴%황연정
胆管癌%预后%肿瘤,残余
膽管癌%預後%腫瘤,殘餘
담관암%예후%종류,잔여
目的 探讨经手术切除肝门胆管癌（hepatichilarcholangocarcinoma,HHCC）手术切缘有无残癌对预后的影响。 方法 比较切缘有残癌组(43例)和无残癌组(40例)患者的临床分型、手术方式、肿瘤分化程度及生存情况。 结果 切缘有残癌组患者1、2、3和5年生存率，分别为37.2%、6.3%、3.5%和2.4%；切缘无残癌组患者分别为82.2%、58.2%、41.6%和27.7%。 结论 手术切缘残癌率与肿瘤分化程度关系密切，在BismuthⅣ型中发生率最高。BismuthⅣ型中的低分化型腺癌患者，手术切除疗效差，对无肝外转移者可以选择肝移植术。
目的 探討經手術切除肝門膽管癌（hepatichilarcholangocarcinoma,HHCC）手術切緣有無殘癌對預後的影響。 方法 比較切緣有殘癌組(43例)和無殘癌組(40例)患者的臨床分型、手術方式、腫瘤分化程度及生存情況。 結果 切緣有殘癌組患者1、2、3和5年生存率，分彆為37.2%、6.3%、3.5%和2.4%；切緣無殘癌組患者分彆為82.2%、58.2%、41.6%和27.7%。 結論 手術切緣殘癌率與腫瘤分化程度關繫密切，在BismuthⅣ型中髮生率最高。BismuthⅣ型中的低分化型腺癌患者，手術切除療效差，對無肝外轉移者可以選擇肝移植術。
목적 탐토경수술절제간문담관암（hepatichilarcholangocarcinoma,HHCC）수술절연유무잔암대예후적영향。 방법 비교절연유잔암조(43례)화무잔암조(40례)환자적림상분형、수술방식、종류분화정도급생존정황。 결과 절연유잔암조환자1、2、3화5년생존솔，분별위37.2%、6.3%、3.5%화2.4%；절연무잔암조환자분별위82.2%、58.2%、41.6%화27.7%。 결론 수술절연잔암솔여종류분화정도관계밀절，재BismuthⅣ형중발생솔최고。BismuthⅣ형중적저분화형선암환자，수술절제료효차，대무간외전이자가이선택간이식술。
Objective To review 83 resected hilar cholangiocarcinomas, andanalyse the factors causing residual tumors at resection margins and the influence to survival rate. Methods Bismuth′s classification, surgical procedures,tumor differentiation, and survival time were compared between the positive or negative group at resection margins. Results The 1-,2-,3- and 5-year survival rates of the positive group (43 patients) were 37.2%,6.3%,3.5% and 2.4%, respectively, while those of the negative group (40 patients) was 82.2%,58.2%,41.6% and 27.7%. Conclusions There was a significant relationship between the rate of residual tumor margins and tumor differentiation; the highest rate of residual tumor was observed in Bismuth Ⅳ. The patients with lower differentiation in Bismuth Ⅳ have a poor prognosis for surgical resection; but there is no evidence of extrahepatic spread, and liver transplantation liver is feasible.
