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由于胆道癌患者黄疸前缺乏特异症状,而且癌肿早期侵犯门静脉、肝动脉及胆管周围组织,因此虽然最近在直接胆管造影方面有所进展,但早期诊断仍很困难。有时诊断确定之后已不可能作根治手术,因而术后不能取得满意的结果。京都大学医院第一外科对1965年3月至1978年5月内作过手术的70例胆道癌进行了临床病理分析。作者等将肝外胆管分为上、中、下三部分,上段包括左右肝管及其汇合部,下段指十二指肠后及胰腺内的胆总管,位于上下段之间者为中段。50例胆管癌中,上段15例,中段15例,下段20例;另乏特氏壶腹癌20例。
Because of the lack of specific symptoms before jaundice in patients with biliary tract cancer, and the early invasion of the portal vein, hepatic artery, and bile duct tissue in early cancer, although there has been recent progress in direct cholangiography, early diagnosis is still difficult. Sometimes it is impossible to perform radical surgery after the diagnosis is confirmed, and thus satisfactory results cannot be obtained after the operation. The first surgery of Kyoto University Hospital performed a clinicopathological analysis of 70 cases of cholangiocarcinoma that had undergone surgery from March 1965 to May 1978. The authors divided the extrahepatic bile duct into upper, middle, and lower parts. The upper part includes the left and right hepatic ducts and its confluence, the lower part refers to the duodenum and the common bile duct in the pancreas, and the middle part between the upper and lower segments. Of the 50 cases of cholangiocarcinoma, 15 cases were in the upper segment, 15 in the middle segment, and 20 in the lower segment. Twenty patients with ampulla of T. pneumoniae were absent.