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目的探讨肝胆管结石合并胆管癌的诊治经验。方法总结2000—2010年本院收治的31例肝胆管结石合并胆管癌患者的临床资料。结果术前超声检查诊断率为45.2%(14/31)。术前CT诊断正确率为64.5%(20/31)。根治性手术7例,病理诊断为胆管腺癌及黏液癌。随访19例,根治组平均存活18个月,姑息治疗组平均存活8个月。结论胆管癌的发生与肝胆管结石有关,伴有结石的胆管癌疗效较差,应重视胆管结石的早期根治性治疗,以防止胆管癌的发生,姑息性手术可提高生活质量。
Objective To investigate the diagnosis and treatment of hepatolithiasis with cholangiocarcinoma. Methods The clinical data of 31 patients with hepatolithiasis admitted to our hospital from 2000 to 2010 were summarized. Results The diagnostic rate of preoperative ultrasonography was 45.2% (14/31). The correct rate of preoperative CT diagnosis was 64.5% (20/31). Radical surgery in 7 cases, pathological diagnosis of cholangiocarcinoma and mucinous carcinoma. The follow-up of 19 cases, the average survival of the radical group of 18 months, palliative treatment group, the average survival of 8 months. Conclusions The occurrence of cholangiocarcinoma is related to hepatolithiasis. The treatment of cholangiocarcinoma with calculi is less effective. Early radical treatment of choledocholithiasis should be emphasized to prevent the occurrence of cholangiocarcinoma. Palliative surgery can improve the quality of life.