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目的 观察肝叶切除在肝门部胆管癌根治术中的疗效并探讨根治性切除术的范围。方法 自 1995年 2月至 1997年 3月手术切除肝门部胆管癌 9例 ,姑息性切除 2例 ,根治性切除 7例 ,8例行各种类型肝切除。结果 姑息性切除 1例术后 12个月发生肝内转移 ,存活 16个月 ;另 1例仍存活 ,术后 2 7个月出现阻塞性黄疸。根治性切除 1例术后 11d死于肺部感染 ,其余存活至今。结论 肝切除术是肝门部胆管癌根治性切除术中的重要组成部分 ,应根据肿瘤类型、浸润情况和术中病理结果决定切除范围。门静脉受浸润不是根治性切除的绝对禁忌证。
Objective To observe the effect of hepatectomy on radical resection of hilar cholangiocarcinoma and explore the scope of radical resection. Methods From February 1995 to March 1997, 9 cases of hilar cholangiocarcinoma were removed, 2 cases were palliative resection, 7 cases were radical resection, and 8 cases were performed with various types of hepatectomy. Results Palliative resection occurred in 12 patients within 12 months after operation and survived for 16 months. The other case was still alive. Obstructive jaundice occurred at 27 months after operation. Radical resection 1 patient died of lung infection 11 days after the operation, and the rest survived to this day. Conclusions Liver resection is an important part of radical resection of hilar cholangiocarcinoma. The scope of resection should be determined according to the type of tumor, invasive condition and intraoperative pathological results. Infiltration of the portal vein is not an absolute contraindication to radical resection.