肝门部胆管癌临床诊断与放疗疗效分析

目的：探讨不同手术方式治疗肝门部胆管癌的效果及其对术后放疗的影响。方法：回顾性分析我科自2008年6月至2012年6月间收治的60例肝门部胆管癌患者的临床资料，根据手术方式不同，将所选病例分为两组，其中26例接受根治性切除术，34例患者采用姑息性手术进行治疗。对比不同手术方式下放疗后患者生存情况。结果：围手术期死亡1例。两组患者各有2例患者失访。随访的23例根治手术患者1、3、5年间的生存率为19（82．6％）、10（43．5％）、2（8．7％）；32例姑息性手术患者1、3、5年间的生存率为15（46．9％）、4（12．4％）、0（0％）。根治性手术后患者1、3、5年间的生存率显著性高于姑息性手术治疗的患者，差异具有统计学意义（P〈0．05）。结论：通过术前影像学诊断，选择合理的手术方式，联合术后放疗，可有效延长肝门部胆管癌患者的生存时间。

Diagnosis and Effects of the Radiotherapy on Hilar Cholangiocarcinoma

Objective： To investigate the clinical effects of different operation methods combined with the radiotherapy on the treatment of hilar cholangiocarcinoma. Methods： A retrospective analysis was conducted about 60 cases with hilar cholangiocarcinoma who were treated in our hospital from June 2008 to June 2012. Results： The rate of misdiagnosis was high without specific symptoms in the early stage. There was one died when undergoing the radical surgery, and two cases were missed the follow-up in each group. The median survival time of 23 patients treated by radical resection was 30 months with the 1, 3, 5-year survival rate 19（82.6%）, 0（43.5%）, 2 （8.7%） respectively. While the median survival time of the non-radical 32 patients was 16 months with the 1, 3, 5-year survival rate 15 （46.9%）, 4 （12.4%）, 0 （0%） respectively. Conclusions： It is indicated that a reasonable surgical approach combined with postoperative radiotherapy should be performed by the preoperative imaging diagnosis in order to effectively extend the hilar survival time of patients.