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我院1986年～1995年间共收治肝门部胆管癌39例,其中手术探查24例,切除15例,切除率62.5％。现结合手术切除病例对肝门部胆管癌的诊断和手术切除治疗的有关问题作一探讨。 临床资料 1.一般资料:男7例,女8例,年龄45～70岁,平均58.2岁。临床主要表现为阻塞性黄疸,其中10例伴有上腹部胀痛。病程1周～3个月,平均40.5天。全组病例均有不同程度血清胆红素增高,其中超过171μmol/L8例,最高达583.1μmol/L。1例合并有血吸虫病性肝硬化。均以B超为首选检查,同时行CT检查9例。全部病例术前行PTC,获得明确诊断。 2.胆管癌类型和手术方式:按Bismuth的肝门部胆管癌分型法分型,本组I型5例,Ⅱ型4例,Ⅲ型4例,Ⅳ型2例。行胆管癌切除、左右肝管整形、胆肠
From 1986 to 1995, 39 cases of hilar cholangiocarcinoma were treated in our hospital. Among them, 24 cases were surgically examined and 15 cases were removed. The resection rate was 62.5%. Now we discuss the diagnosis and surgical treatment of hilar cholangiocarcinoma in combination with surgical resection. Clinical data 1. General information: 7 males and 8 females, aged 45 to 70 years, mean 58.2 years old. The main clinical manifestations of obstructive jaundice, including 10 cases with upper abdominal pain. Duration of 1 week to 3 months, an average of 40.5 days. The serum levels of serum bilirubin were increased in all groups, with more than 171 μmol/L in 8 cases and up to 583.1 μmol/L. One patient had schistosomiasis cirrhosis. B-ultrasound was the first choice for examination, while CT examination in 9 cases. All patients underwent PTC preoperatively for a definitive diagnosis. 2. Cholangiocarcinoma types and surgical methods: According to Bismuth’s classification of hilar cholangiocarcinoma, 5 cases were type I, 4 cases were type II, 4 cases were type III, and 2 cases were type IV. Resection of bile duct cancer, left and right hepatic duct reshaping, biliary intestine