摘要
目的探讨围肝门切除(肝外胆管联合局部肝切除)加肝肠吻合术治疗Bismuth-Corlette Ⅲ型肝门部胆管癌(hilar cholangiocarcinoma,HCCA)的疗效。方法统计安徽医科大学第一附属医院肝胆胰外科2002年1月至2012年12月治疗的37例Bismuth-Corlette Ⅲ型HCCA患者的基线资料。根据手术方式不同分成两组,A组:围肝门切除+肝肠吻合术(n=17),B组:肝外胆管联合半肝和半侧尾状叶切除+胆肠吻合术(n=20);分析临床资料及随诊资料,并计算生存率(OS)。结果两组临床资料及生存率(OS)相比较,均无明显差异,术后急性肝功能衰竭的发生率A组小于B组(χ2=5,332,P=0.021),余并发症无差异。结论对Bismuth-Corlette Ⅲ型HCCA的患者,围肝门切除(肝外胆管联合局部肝切除)加肝肠吻合术可减少术后急性肝功能衰竭的发生率。
Objective To evaluate the result of peri-hilar resection(extrahepatic bile duct resection plus local hepatectomy) and hepaticojejunostomy for the treatment of Bismuth-Corlette type Ⅲ hilar cholangiocarcinoma (HCCA). Methods This study was conducted on 37 patients divided into group A undergoing peri-hilar resection (extrahepatic bile duct resection combined with local hepatectomy) and hepaticojejunostomy (n=17) and group B treated by extrahepatic bile duct combined with hemihepatectomy and hemicaudatectomy and cholangioenterostomy (n=20). Results The incidence of postoperative acute liver failure was lower in group A than in group B (χ2=5,332,P=0.021).There was no significant difference in clinical data and survival rate (OS) between the two groups of patients and other complications. Conclusion For patients with Bismuth-Corlette type Ⅲ HCCA,the peri-hilar resection(extrahepatic bile duct combined with local hepatectomy)and hepaticojejunostomy reduces the incidence of postoperative acute liver failure.
作者
戴伟
钱叶本
Dai Wei;Qian Yeben(Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital,Anhui Medical University,Hefei 230022,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2019年第1期14-17,共4页
Chinese Journal of General Surgery
基金
安徽省自然科学研究基金资助项目(1508085MH173).
关键词
胆管肿瘤
肝切除术
吻合术
外科
肝功能衰竭
急性
Bile duct neoplasms
Hepatectomy
Anastomosis, surgical
Liver failure, acute
