目的 分析总结肝门部胆管癌外科手术治疗的经验及预后情况。方法 回顾性分析2011年1月—2017年12月在首都医科大学附属北京朝阳医院肝胆外科行手术治疗的49例肝门部胆管癌患者的临床资料及随访结果。49例患者中,依据患者情况,39例患者采用R0切除,10例患者采用R1切除。分析患者的总体预后及R0切除率。所有患者均通过门诊或电话随访,随访截止日期为2017年12月,比较患者的R0与R1切除的远期预后;正态分布数据以均数±标准差(Mean±SD)表示,非正态分布数据采用M(P25,P75)表示。以Kaplan-Meier法描绘生存曲线,Log-Rank检验比较生存率。结果 49患者均顺利完成手术,5 例患者发生术后并发症,发生率为10.2%,无死亡患者。R0手术患者为39 例,R0切除率为79.6%。通过随访得出,患者的总体中位生存时间是(27.0±1.2) 个月,术后6 个月、1 年、3 年、5 年生存率分别为95.9%、85.6%、34.5%、6.6%,R0切除和R1切除的总体中位生存时间分别是(28.0±6.5) 个月和(16.0±0.7) 个月,术后6 个月、1 年、2 年、3 年生存率分别为94.9%、89.7%、43.5%、8.3%和80.0%、68.6%、0、0。结论 外科手术治疗肝门部胆管癌是安全、有效的,可以改善患者预后。
Objective To analyse the experience and prognosis of surgical treatment of hilar cholangiocarcinoma. Methods Clinical data of 49 patients of hilar cholangiocarcinoma underwent surgical treatment were analyzed retrospectively from January 2011 to December 2017 in Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital affiliated to Capital Medical University. Of the 49 patients, 29 patients underwent R0 resection and 10 patients underwent R1 resection according to the patient′s condition. The overwall prognosis and R0 resection rate were analyzed.All patients were followed up by outpatient or telephone. The follow-up deadline was December 2017. The long-term prognosis of R0 and R1 resection were compared. Normal distribution data were expressed as (Mean±SD), while non-normal distribution data were expressed as M(P25, P75). Survival curve was depicted by Kaplan-Meier method, and survival rate was compared by Log-Rank test. Results All patients underwent surgical treatment. There were 5 complications (10.2%) during the perioperative period, and no deaths occurred. Radical resection was performed in 39 patients, with a radical resection rate of 79.6%. The overall median survival time was (27.0±1.2) months. The survival rates in 6 months, 1, 3 and 5 years were 95.9%, 85.6%, 34.5%, 6.6% respectively. The total median survival time of R0 resection and R1 resection was (28.0±6.5) months and (16.0±0.7) months respectively. The 6 months, 1, 2, and 3 years survival rates were 94.9%, 89.7%, 43.5%, 8.3% and 80.0%, 68.6%, 0, 0 respectively. Conclusion Surgical treatment is safe and effective, and it can improve the prognosis of patients.
International Journal of Surgery
Bile duct neoplasms