Objective To study the data of combined hepatocellular cholangiocarcinoma (CHCC) and to explore its clinical characteristics and prognostic factors. Methods Clinical data of 41 patients with radical resection of CHCC were retrospectively analyzed, and the prognostic factors were analyzed by univariate and multivariate analysis. Results In 36.6% cases of 41 patients with CHCC, the elevated levels of both AFP and CA19-9 were detected. And 78.0% cases got the elevated levels of CK7 and (or) CK19 and Glypcian-3 and (or) hepatocyte. Multiple analysis revealed lymph node involvement was independent prognostic factor for overall survival. Conclusions CHCC is a special type of primary liver cancer and shows some intermediated characteristics between hepatocellular carcinoma and cholangiocarcinoma. The long-term survival of the patients should be affected by the residual of metastasis lymph nodes, and the surgical treatment should be individualized at the present stage.
【摘要】 目的 總結腹腔鏡對小兒美克爾憩室的臨床診斷和應用價值。 方法 2005年4月-2009年12月，將41例行美克爾憩室切除術患兒隨機分為兩孔法腹腔鏡手術組和傳統手術組，就手術治療、術后并發癥、術后效果等臨床資料進行對比分析。 結果 腹腔鏡手術組患兒手術時間、術中出血量、下床活動時間、住院時間等均優于傳統手術組；術后并發癥發生例數均明顯少于傳統手術組。 結論 腹腔鏡對患兒美克爾憩室的診斷和治療具有明顯優越性，可作為小兒美克爾憩室治療的首選方式。【Abstract】 Objective To investigate the diagnostic and applicative value of laparoscopy for Meckel’s diverticulum in children. Methods The clinical data of 41 children with Meckel’s diverticulum who underwent resection between April 2005 to December 2009 were retrospectively analyzed. The patients were divided into tow-port laparoscopy-assisted resection group (group A,19 patients) and traditional resection group (group B, 22 patients). The intra-operative accidental injury, postoperative complications, postoperative general condition and prognosis were evaluated via randomized contrast analysis. Results The time of operation, amount of bleeding, recover intestinal peristalsis,out-of-bed activities time and the average days in hospital in group A were less than those in group B. The postoperative complications occurred in one and eight patients in group A and B respectively. Conclusion Laparoscopy had obvious superiority for the children’s Meckel’ s diverticulum in diagnosis and treatment,which should be the best choice.