CAJ | 학술논문

目的探讨肝门部胆管癌手术术后常见并发症的发生及转归情况.方法根据相关纳入标准回顾性分析解放军总医院2010年1月-2014年12月连续595例行手术治疗的肝门部胆管癌患者的临床资料,对患者的一般资料、并发症及愈后情况进行统计.将患者按照手术方式的不同分为根治组(n=363例)和姑息组(n=232例),比较两组患者并发症的发生情况.结果所有患者均顺利完成手术,术后共发生并发症161例,发病率为27.1％,围手术期死亡患者17例,病死率为2.9％.胆瘘和伤口感染是肝门部胆管癌术后最常见的并发症,发病率分别为16.3％和7.6％.根治组患者在术后并发症总体发病率、术后胆瘘、腹腔感染发病率方面明显高于姑息组患者(P＜0.05),而在术后伤口感染、腹腔出血、循环衰竭、肺部感染、上消化道出血等并发症发病率方面两组患者之间无统计学差异(P＞0.05).结论肝门部胆管癌尤其是行根治性手术的患者术后并发症发病率高,胆瘘和感染是其最常见的并发症.
목적 탐토간문부담관암수술술후상견병발증적발생급전귀정황.방법 근거상관납입표준회고성분석해방군총의원2010년1월-2014년12월련속595례행수술치료적간문부담관암환자적림상자료,대환자적일반자료、병발증급유후정황진행통계.장환자안조수술방식적불동분위근치조(n=363례)화고식조(n=232례),비교량조환자병발증적발생정황.결과 소유환자균순리완성수술,술후공발생병발증161례,발병솔위27.1％,위수술기사망환자17례,병사솔위2.9％.담루화상구감염시간문부담관암술후최상견적병발증,발병솔분별위16.3％화7.6％.근치조환자재술후병발증총체발병솔、술후담루、복강감염발병솔방면명현고우고식조환자(P＜0.05),이재술후상구감염、복강출혈、순배쇠갈、폐부감염、상소화도출혈등병발증발병솔방면량조환자지간무통계학차이(P＞0.05).결론 간문부담관암우기시행근치성수술적환자술후병발증발병솔고,담루화감염시기최상견적병발증.
Objective To investigate the incidence and outcome of complication after hilar cholangiocarcinoma operation.Methods Retrospectively analyzed the clinical data of 595 hilar cholangiocarcinoma patients underwent operation in PLA General Hospital between Jan.2010 and Dec.2014 according to the inclusion criteria.And divided the patients into two groups according to different operation:the radical operation group (n =363) and the conservative operation group (n =232).The general data,postoperative complications and outcome datas were statistical analysis.Results All of the patients were successfully finished the operation.The postoperative complications occurred in 161 cases,the incidence was 27.1％.And there were 17 patients dead,the mortality was 2.9％.The most complications were biliary fistula and wound infection,the incidence rates were 16.3％ and 7.6％.The incidences of complication,biliary fistula and peritoneal infection in the radical operation group patients were significantly higher than the conservative operation group patients (P ＜ 0.05).And the incidences of wound infection,intra-abdominal hemorrhage,circulatory failure,pulmonary infection,upper gastrointestinal hemorrhage and other complications had no statistical difference between the two groups (P ＞ 0.05).Conclusion The hilar cholangiocarcinoma especially underwent radical operation patients had high incidence rate of postoperative complications.Biliary fistula and infection were the most common complications.