Surgery for hilar cholangiocarcinoma: an Italian experience.
Surgery for hilar cholangiocarcinoma: an Italian experience.
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DOI：
10.1007/s005340050165
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发表时间：
2000-01-01
期刊：
影响因子：
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通讯作者：
Mori, L
中科院分区：
文献类型：
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作者：
Gazzaniga, G M;Filauro, M;Mori, L
自1980年1月至1997年6月，我院共收治肝管汇合部癌159例。75例患者接受了手术切除（总切除率：47.2%），46例患者（根治性切除率：28.9%），在我们的分期系统的前三个阶段分类的尝试根治性切除。围手术期死亡率为10%（16例患者）。46例根治性切除患者的5年生存率为17.5%，中位生存期为19个月。接受联合尾状叶切除术的患者（n = 17）的5年生存率为25%，而未接受联合尾状叶切除术的患者的5年生存率为0。两组结果差异有统计学意义。强调了仔细的术前分期的重要性。术前检查应仅限于提供肿瘤内和外胆管扩散的大部分信息的检查（超声多普勒扫描、螺旋计算机断层扫描、经皮经肝胆管胆管造影）。最后，我们强调切除作为唯一可能提高长期生存率的治疗方法的重要性。基于这些结果，始终建议在肿瘤切除治疗的同时进行尾状叶切除术。
From January 1980 to June 1997 we treated 159 patients with carcinoma of the hepatic duct confluence. Seventy-five patients underwent surgical resection (overall resectability rate: 47.2%), and radical resection was attempted in 46 patients (radical resectability rate: 28.9%) classified in the first three stages of our staging system. Perioperative mortality was 10% (16 patients). The 5-year survival rate for 46 patients with curative resection was 17.5% with a median survival of 19 months. The 5-year survival rate for those patients who underwent combined caudate lobectomy (n = 17) was 25%, whereas the survival rate for those who did not was zero. The difference between these two groups' results was statistically significant. The importance of careful preoperative staging is stressed. Preoperative tests should be limited to investigations (ultrasound with Doppler scan, spiral computed tomography, percutaneous transhepatic cholangiography) supplying most information about intra- and extrabiliary diffusion of the tumoral mass. We conclude by highlighting the importance of resection as the only treatment potentially improving long-term survival. On the basis of these results, caudate lobectomy is always recommended in association with resectional treatment of the neoplasm.