Combined caudate lobectomy radical resection and lymph node dissection for hilar cholangiocarcinoma

中华普通外科杂志 Pub Date : 2019-12-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2019.12.001

Zhedong Zhang, Dafang Zhang, Wenyong Xie, Weihua Zhu, Jiye Zhu, X. Leng, Shu Li

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Abstract

Objective To investigate the clinical efficacy and prognostic factors for combined caudate lobectomy radical resection plus broad lymph node dissection in patients of hilar cholangiocarcinoma. Methods The clinical data and follow-up results of patients with hilar cholangiocarcinoma surgically treated from Feb 2008 to Feb 2017 were retrospectively analyzed. Result The R0 resection rate[72.2%(13/18)vs 43.9%(18/41)], operation time[(433±136)min vs(302±122)min], intraoperative blood loss [(1 789±1 091)ml vs(776±755)ml]and postoperative complication rate[66.7%(12/18)vs 36.6%(15/41)]were significantly higher in the hepatic lobe combined with caudate lobe resection group than that without caudate lobe resection group (P 1 000 U/ml, the degree of microscopic margin and tumor TNM stage were significantly correlated with the prognosis of the patients (P<0.05). Conclusion Combined with caudate lobe resection can improve R0 resection rate. Targeted lymph node dissection helps prolong survival. The degree of microscopic margin, preoperative CA199 and TNM staging are independent risk factors for the prognosis of patients with hilar cholangiocarcinoma. Key words: Bile duct neoplasms; Lymph node excision; Comparative effectiveness research

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肝门部胆管癌尾状叶切除术联合根治性切除及淋巴结清扫

目的探讨肝门部胆管癌尾状叶切除联合广泛淋巴结清扫术的临床疗效及影响预后的因素。方法回顾性分析2008年2月至2017年2月手术治疗的肝门部胆管癌患者的临床资料和随访结果。结果R0切除率为72.2%（13/18）vs 43.9%（18/41）、手术时间为（433±136）min vs（302±122）min，术中出血量[（1789±1091）mlvs（776±755）ml]和术后并发症发生率[66.7%（12/18）vs 36.6%（15/41结论联合尾状叶切除可提高R0切除率。有针对性的淋巴结清扫有助于延长生存期。肝门部胆管癌的镜下边缘程度、术前CA199和TNM分期是影响患者预后的独立危险因素。关键词：胆管肿瘤；淋巴结切除术；比较有效性研究

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中华普通外科杂志

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