对侵犯内脏静脉的周围胆管癌患者进行胆总管重建术的即时效果

O. Usenko, A. I. Zhylenko
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摘要

目的评估对侵犯内脏静脉的周围胆管癌患者进行胆道重建的即时效果。材料和方法。2004 年至 2018 年期间,乌克兰国家医学科学院沙利莫夫国立外科和移植研究所(现为乌克兰国家医学科学院沙利莫夫国立外科和移植科学中心)肝脏移植和外科部对 28 名内脏静脉受侵的周围胆管癌患者进行了根治性手术。主组包括8名(28.6%)患者,他们在切除和重建内脏静脉的同时进行了胆道重建;对照组包括20名(71.4%)患者,他们在切除和重建内脏静脉的同时没有进行胆道重建。结果在术后90天内,主治组和对照组分别有12.5%和25%的患者出现了明显的临床并发症(根据Clavien-Dindo分类法为IIIaIV级)(P=0.002),根据国际肝脏外科研究小组的标准,分别有25%和30%的患者出现了术后肝功能衰竭(P=0.415)。分别有12.5%和10%的患者进行了再次手术(P=0.923)。两组患者均无术后死亡。结论对侵犯内脏静脉的周围胆管癌患者进行胆总管重建术的近期效果令人满意。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immediate results of biliodigestive reconstruction in patients with peripheral cholangiocarcinoma with invasion of visceral veins
Objective. To evaluate the immediate results of biliodigestive reconstruction in patients with peripheral cholangiocarcinoma with invasion of the visceral veins. Materials and methods. From 2004 to 2018, 28 patients with peripheral cholangiocarcinoma with invasion of the visceral veins were radically operated at the Department of Liver Transplantation and Surgery of the Shalimov National Institute of Surgery and Transplantation of the National Academy of Medical Sciences of Ukraine (now the Shalimov National Scientific Centre of Surgery and Transplantation of the National Academy of Medical Sciences of Ukraine). The main group consisted of 8 (28.6%) patients who underwent biliodigestive reconstruction simultaneously with resection and reconstruction of visceral veins, the control group consisted of 20 (71.4%) patients who underwent resection and reconstruction of visceral veins, and biliodigestive reconstruction was not performed. Results. Postoperative clinically significant (grade IIIa­IV according to the Clavien­Dindo classification) complications during the 90­day postoperative period were noted in 12.5% of patients in the main group and 25% of patients in the control group (p=0.002), postoperative liver failure according to the criteria of the International Study Group on Liver Surgery ­ in 25 and 30%, respectively (p=0.415). Repeat surgery was performed in 12.5 and 10% of patients, respectively (p=0.923). There was no postoperative mortality in both study groups. Conclusions. The immediate results of biliodigestive reconstruction in patients with peripheral cholangiocarcinoma with invasion of the visceral veins are satisfactory.
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