CAJ | 학술논문

目的通过对肝细胞肝癌合并胆总管癌栓手术病例临床资料的回顾性分析,探讨不同手术方式的疗效以及对远期预后的影响.方法 2008年1月-2012年12月,北京协和医院肝脏外科收治肝细胞肝癌合并胆总管癌栓行手术病例共9例,5例病例行根治性半肝切除术,3例行肝部分切除术,1例行术中射频,全部病例均行胆总管探查取栓术;术后通过数字减影血管成像技术进行随诊;全部病例术后随访时间均超过12个月.结果全部手术病例术后黄疸指数均明显下降,根治性手术病例术后无瘤生存时间、生存时间均略优于姑息手术病例,术后再次胆道梗阻发病率也低于姑息手术病例.结论肝细胞肝癌合并胆总管癌栓病例通过适当的手术方式可以达到切除肿瘤、解除胆道梗阻的目的,根治性半肝切除术的疗效优于肝部分切除术.
목적 통과대간세포간암합병담총관암전수술병례림상자료적회고성분석,탐토불동수술방식적료효이급대원기예후적영향.방법 2008년1월-2012년12월,북경협화의원간장외과수치간세포간암합병담총관암전행수술병례공9례,5례병례행근치성반간절제술,3례행간부분절제술,1례행술중사빈,전부병례균행담총관탐사취전술;술후통과수자감영혈관성상기술진행수진;전부병례술후수방시간균초과12개월.결과 전부수술병례술후황달지수균명현하강,근치성수술병례술후무류생존시간、생존시간균략우우고식수술병례,술후재차담도경조발병솔야저우고식수술병례.결론 간세포간암합병담총관암전병례통과괄당적수술방식가이체도절제종류、해제담도경조적목적,근치성반간절제술적료효우우간부분절제술.
Objective To explore the efficacy of different surgical methods and the impact on long-term prognosis,viathe retrospective analysis of surgical patients with hepatocellular carcinoma (HCC) and common bile duct tumor thrombus.Methods From Jan.2008 to Dec.2012,our center treated 9 HCC patients with common bile duct tumor thrombus underwent surgery.5 cases underwent radical half liver resection,3 cases underwent partial hepatectomy,1 case underwent intraoperative radiofrequency,all patients underwent common bile duct exploration thrombectomy.Postoperative follow-up conducted by digital subtraction angiography (DSA).All patients were followed up for more than 12 months.Results The postoperative jaundice indexes of all the surgical patients were significantly decreased.The diseases free survival time and total survival time of patients underwent radical surgery were slightly better than that of palliative surgical cases.The incidence of postoperative biliary obstruction of patients underwent radical surgery were lower than that of palliative surgical cases.Conclusions HCC patients with common bile duct tumor thrombus through the appropriate surgical methods can achieve the purpose of removal of the tumor and relieve biliary obstruction.The curative effect of radical half liver resection is better than that of partial hepatectomy.