肝门部胆管癌46例临床分析
张丽莉;朱颖炜;谈春晓;龚镭;
摘要(Abstract)：
目的:探讨肝门部胆管癌的诊断方法、临床特征和内镜下支架置入术及外科手术治疗的效果。方法:根据病情对46例肝门部胆管癌患者分别行根治性切除、支架置入或剖腹探查术,姑息性切除引流或内镜治疗。结果:行根治术8例中单纯性根治性切除5例,联合肝段肝叶切除2例,联合胰十二指肠切除1例;姑息治疗12例中姑息性切除4例,内引流3例,外引流5例。内镜治疗26例中置内支架23例,分别为单侧塑料支架17例,双侧塑料支架3例,单侧金属支架3例。术中发生胆瘘1例,腹腔内感染或脓肿2例。根治性切除存活17.03±8.02个月,姑息性手术存活6.70±3.07个月。内镜治疗存活6.67±2.38个月。患者更换支架的平均时间为5.23±3.32个月。结论:影像学诊断对肝门部胆管癌的定位诊断及提高早期诊断率有重要价值。根治性切除是改善肝门部胆管癌预后的重要措施,内镜下支架置入术对改善患者生活质量和预后有一定的价值。
关键词(KeyWords)： 胆管癌;剖腹探查术;姑息切除引流术;内镜下支架置入术
基金项目(Foundation):
作者(Authors): 张丽莉;朱颖炜;谈春晓;龚镭;
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