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目的 探讨胆管内梗阻型原发性肝细胞癌 (简称梗阻型肝癌 )的诊治方法。方法 回顾性分析 36例病人的临床资料并将其分成两组 :胆管探查“T”管引流组 (简称引流组 ) 18例 ;一期或分期肝切除组 (简称肝切除组 ) 18例。计算两组术后平均生存时间并进行统计学分析。结果 36例胆管内均发现栓子 ,病理学检查报告均为肝细胞癌栓。引流组、肝切除组的术后平均生存时间 (月 )分别为 (6± 5 )个月、(15± 13)个月 (P <0 0 5 )。结论 黄疸不一定是梗阻型肝癌的晚期表现 ,也不一定是手术禁忌证 ,一期或分期肝切除术常可获得较长术后生存时间。胆管内栓子的病理学检查是确诊的关键。
Objective To investigate the diagnosis and treatment of intrahepatic biliary obstruction type of primary hepatocellular carcinoma (referred to as obstructive hepatocellular carcinoma). Methods The clinical data of 36 patients were retrospectively analyzed and divided into two groups: 18 cases of “T” tube drainage group (abbreviated as drainage group) and 18 cases of primary or staged liver resection group (referred to as liver resection group). The average postoperative survival time was calculated and statistically analyzed. Results Thirty-six cases of embolism were found in the bile duct, pathological examination report were hepatocellular carcinoma thrombus. The mean postoperative survival time (months) in the drainage group and hepatectomy group were (6 ± 5) months and (15 ± 13) months, respectively (P <0.05). Conclusion Jaundice is not necessarily the late manifestation of obstructive hepatocellular carcinoma, nor is it a contraindication for surgery. One-stage or staged hepatectomy often leads to longer postoperative survival time. Pathological examination of intrahepatic emboli is the key to diagnosis.