Effective Therapeutic Method of PTCD for Hilar Cholangiocarcinoma: A Clinical Analysis of 67 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YANGYi , JIZong-zheng , WUTao , XUXin , ZHANGXin-wu ,  CHENXi

Department of General Surgery, The Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China;

Corresponding?author：

CHENXi, Email: 2002chenxi@163.com

Keywords：

Hilar cholangiocarcinoma; Percutaneous transhepatic choledochus drainage; Bile drainage; Radical surgery; Palliative surgery

DOI：

10.7507/1007-9424.20140069

Video：

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Objective To analyze effect of percutaneous transhepatic choledochus drainage (PTCD) for hilar cholangiocarcinoma. Methods Clinical data of 67 cases of hilar cholangiocarcinoma who treated in our hospital from Jan. 2005 to Dec. 2010 were retrospectively analyzed. Results Of the 67 cases, 30 cases were performed PTCD, 20 cases were performed radical surgery after PTCD, and 17 cases were performed palliative surgery after PTCD. There were 59 cases who were followed-up for 3-30 months, and the median time was 9.3 months. The median survival time of patients who underwent PTCD, radical surgery, and palliative surgery were 10.2, 21.4, and 8.9 months respectively. The survival of patients who underwent radical surgery was better than those of underwent PTCD (χ²=13.6, P=0.000 4) and palliative surgery (χ²=15.2, P=0.003 8), and survival of patients who underwent PTCD was better than patients underwent palliative surgery (χ²=5.3, P=0.040 1). Conclusions PTCD is contribute to preoperative diagnosis and evaluation, in addition, it can reduce unnecessary surgical exploration, guarantee the safety of the radical surgery, and provide follow-up care for palliative operation channel which is favorable for local internal radiation therapy.

Citation： YANGYi, JIZong-zheng, WUTao, XUXin, ZHANGXin-wu, CHENXi. Effective Therapeutic Method of PTCD for Hilar Cholangiocarcinoma: A Clinical Analysis of 67 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(3): 285-288. doi: 10.7507/1007-9424.20140069 Copy

1.	?黃志強.肝門部膽管癌外科治療面臨的問題與出路[J].中華實驗外科雜志, 2004, 21(7):773-775.
2.	黃志強.肝門部膽管癌外科治療——我們要走向何方?[J].肝膽外科雜志, 2003, 11(5):321-322.
3.	Kondo S, Hirano S, Ambo Y, et al. Forty consecutive resections of hilar cholangiocarcinoma with no postoperative mortality and no positive ductal margins:results of a prospective study[J]. Ann Surg, 2004, 240(1):95-101.
4.	Bismuth H, Corlette MB. Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver[J]. Surg Gynecol Obstet, 1975, 140(2):170-178.
5.	周寧新.對肝門部膽管癌根治切除手術方式的改進體會[J].中國實用外科雜志, 1999, 19(10):592-594.
6.	李秋, 雷正明, 葉明新, 等.肝門部膽管癌59例外科診治分析[J].現代預防醫學, 2012, 39(10):2598-2599, 2601.
7.	胡筱壯.手術治療高位膽管癌的臨床療效探究[J].中國醫學工程, 2013, 21(10):67.
8.	李波, 嚴律南.肝門膽管癌的診治進展[J].中國普外基礎與臨床雜志, 2005, 12(4):356-360.
9.	Huang ZQ, Zhou NX, Huang XQ. Surgical treatment o f hilar bile duct cancer:a critical review of 291 case[J]. Chinese-German J Clin Oncol, 2003, 2(2):64-71.
10.	萬濤, 周寧新, 徐東剛, 等.膽管癌相關基因FXYD6的克隆及功能區定位[J].中國普外基礎與臨床雜志, 2010, 17(7):707-712.
11.	董家鴻, 曾永毅.梗阻性黃疸研究熱點與難點[J].中國實用外科雜志, 2007, 27(10):768-770.
12.	董家鴻.膽管癌根治性手術的適應證、術式選擇及遠期療效[J].中國實用外科雜志, 2001, 21(8):461-463.
13.	Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma[J]. Ann Surg, 1992, 215(1):31-38.
14.	周寧新.肝門部膽管癌(含膽囊癌)擴大根治術的范圍、術式選擇及評價[J].中國實用外科雜志, 2001, 21(1):18-20.
15.	周寧新, 黃志強, 張文智, 等. 402例肝門部膽管癌臨床分型、手術方式與遠期療效的綜合分析[J].中華外科雜志, 2006, 44(23):1599-1603.
16.	周寧新.肝門部區域解剖與病變特點對手術方式的影響[J].中國實用外科雜志, 2002, 22(7):432-433.
17.	丁義濤.膽管癌的肝移植治療策略回顧與展望[J].器官移植, 2013, 4(2):63-67.
18.	徐川, 施海彬, 劉圣, 等.肝門部膽管癌致梗阻性黃疸介入引流治療的預后分析[J].介入放射學雜志, 2012, 21(9):752-755.
19.	Rerknimitr R, Angsuwatcharakon P, Ratanachu-ek T, et al. Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma[J]. J Gastroenterol Hepatol, 2013, 28(4):593-607.
20.	Tsao JI, Nimura Y, Kamiya J, et al. Management of hilar cholangiocarcinoma:comparison of an American and a Japanese experience[J]. Ann Surg, 2000, 232(2):166-174.
21.	石力, 湯禮軍, 汪濤, 等.膽道金屬支架置入治療肝門部膽管癌的臨床研究[J].中國普通外科雜志, 2012, 21(8):918-921.
22.	袁玉華, 王亞明, 王春泉, 等.術中膽道支架置入聯合碘125粒子腔內照射治療惡性膽道梗阻(附13例報告)[J].肝膽外科雜志, 2013, 21(1):54-55.
23.	施海彬, 劉圣, 王杰, 等.雙途徑介入治療原發性肝癌合并梗阻性黃疸[J].介入放射學雜志, 2003, 12(5):352-354.
24.	李波, 嚴律南, 劉續寶. 32例肝門膽管癌的手術治療[J].華西醫學, 2003, 18(4):467-468.
25.	李波, 劉續寶, 嚴律南, 等. 46例肝門膽管癌的診斷和治療[J].消化外科, 2005, 4(3):162-165.

1. ?黃志強.肝門部膽管癌外科治療面臨的問題與出路[J].中華實驗外科雜志, 2004, 21(7):773-775.
2. 黃志強.肝門部膽管癌外科治療——我們要走向何方?[J].肝膽外科雜志, 2003, 11(5):321-322.
3. Kondo S, Hirano S, Ambo Y, et al. Forty consecutive resections of hilar cholangiocarcinoma with no postoperative mortality and no positive ductal margins:results of a prospective study[J]. Ann Surg, 2004, 240(1):95-101.
4. Bismuth H, Corlette MB. Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver[J]. Surg Gynecol Obstet, 1975, 140(2):170-178.
5. 周寧新.對肝門部膽管癌根治切除手術方式的改進體會[J].中國實用外科雜志, 1999, 19(10):592-594.
6. 李秋, 雷正明, 葉明新, 等.肝門部膽管癌59例外科診治分析[J].現代預防醫學, 2012, 39(10):2598-2599, 2601.
7. 胡筱壯.手術治療高位膽管癌的臨床療效探究[J].中國醫學工程, 2013, 21(10):67.
8. 李波, 嚴律南.肝門膽管癌的診治進展[J].中國普外基礎與臨床雜志, 2005, 12(4):356-360.
9. Huang ZQ, Zhou NX, Huang XQ. Surgical treatment o f hilar bile duct cancer:a critical review of 291 case[J]. Chinese-German J Clin Oncol, 2003, 2(2):64-71.
10. 萬濤, 周寧新, 徐東剛, 等.膽管癌相關基因FXYD6的克隆及功能區定位[J].中國普外基礎與臨床雜志, 2010, 17(7):707-712.
11. 董家鴻, 曾永毅.梗阻性黃疸研究熱點與難點[J].中國實用外科雜志, 2007, 27(10):768-770.
12. 董家鴻.膽管癌根治性手術的適應證、術式選擇及遠期療效[J].中國實用外科雜志, 2001, 21(8):461-463.
13. Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma[J]. Ann Surg, 1992, 215(1):31-38.
14. 周寧新.肝門部膽管癌(含膽囊癌)擴大根治術的范圍、術式選擇及評價[J].中國實用外科雜志, 2001, 21(1):18-20.
15. 周寧新, 黃志強, 張文智, 等. 402例肝門部膽管癌臨床分型、手術方式與遠期療效的綜合分析[J].中華外科雜志, 2006, 44(23):1599-1603.
16. 周寧新.肝門部區域解剖與病變特點對手術方式的影響[J].中國實用外科雜志, 2002, 22(7):432-433.
17. 丁義濤.膽管癌的肝移植治療策略回顧與展望[J].器官移植, 2013, 4(2):63-67.
18. 徐川, 施海彬, 劉圣, 等.肝門部膽管癌致梗阻性黃疸介入引流治療的預后分析[J].介入放射學雜志, 2012, 21(9):752-755.
19. Rerknimitr R, Angsuwatcharakon P, Ratanachu-ek T, et al. Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma[J]. J Gastroenterol Hepatol, 2013, 28(4):593-607.
20. Tsao JI, Nimura Y, Kamiya J, et al. Management of hilar cholangiocarcinoma:comparison of an American and a Japanese experience[J]. Ann Surg, 2000, 232(2):166-174.
21. 石力, 湯禮軍, 汪濤, 等.膽道金屬支架置入治療肝門部膽管癌的臨床研究[J].中國普通外科雜志, 2012, 21(8):918-921.
22. 袁玉華, 王亞明, 王春泉, 等.術中膽道支架置入聯合碘125粒子腔內照射治療惡性膽道梗阻(附13例報告)[J].肝膽外科雜志, 2013, 21(1):54-55.
23. 施海彬, 劉圣, 王杰, 等.雙途徑介入治療原發性肝癌合并梗阻性黃疸[J].介入放射學雜志, 2003, 12(5):352-354.
24. 李波, 嚴律南, 劉續寶. 32例肝門膽管癌的手術治療[J].華西醫學, 2003, 18(4):467-468.
25. 李波, 劉續寶, 嚴律南, 等. 46例肝門膽管癌的診斷和治療[J].消化外科, 2005, 4(3):162-165.

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Effective Therapeutic Method of PTCD for Hilar Cholangiocarcinoma: A Clinical Analysis of 67 Cases

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