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目的探讨老年肝门胆管癌的围手术期处理方法。方法回顾性分析1992年6月-2004年10月收治的60岁以上的肝门胆管癌患者临床资料。结果 78例患者合并有多脏器储备功能改变,施行手术切除12例,外引流手术11例,内引流手术55例。17例出现并发症,以肺部感染、肝肾功能衰竭和吻合口瘘为多见。根治性切除、姑息性切除和姑息性引流组手术后中位生存时间分别为12、8、5个月。结论肝门胆管癌的手术复杂,创伤大,对老年患者更容易产生心肺功能异常及各种并发症;但通过围手术期内合理、充分的综合治疗措施,仍能取得较好的治疗效果。
Objective To investigate the perioperative management of elderly patients with hilar cholangiocarcinoma. Methods The clinical data of patients with hilar cholangiocarcinoma over 60 years old admitted from June 1992 to October 2004 were retrospectively analyzed. Results 78 patients combined with multiple organ reserve changes, the implementation of surgical resection in 12 cases, 11 cases of external drainage, internal drainage of 55 cases. 17 cases of complications, pulmonary infection, liver and kidney failure and anastomotic leakage is more common. The median survival time after radical resection, palliative resection and palliative drainage were 12, 8 and 5 months respectively. Conclusions Hilar cholangiocarcinoma is complicated and traumatic, and it is more likely to cause cardiopulmonary dysfunction and various complications in elderly patients. However, it is still possible to obtain better therapeutic effects through rational and adequate comprehensive treatment during perioperative period.