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目的研究分析肝胆管结石和胆管癌的关联,从而总结肝胆管结石合并胆管癌在临床中的诊断治疗方法。方法在2000年2月～2012年9月来我院进行病理检查确诊为肝内胆管结石的患者共490例,其中合并胆管癌的患者共18例,本文对18例患者临床资料进行回顾性分析。结果在患肝内胆管结石的490例资料中,合并胆管癌患者占3.7%,共18例。其中,有34.2%的肝胆管癌,41.0%的肝门部胆管癌;18.0%的肝外胆管癌;6.8%的壶腹部癌。这18例胆管癌患者全部接受了手术治疗,正确诊断率为22.2%,有4例;其中有27.8%的患者术中病变细胞根本切除,共5例,而治疗后效果欠佳,术后1年的生存率为25.7%,2年的生存率仅为14.3%。结论研究分析发现,在胆管结石合并胆管癌的患者中,45岁以上的患病率居多,所以在临床诊断中,对45岁以上,患肝胆管结石病程超过10年,且出现消瘦、腹痛加剧不易缓解等问题的患者,应对其进行相应诊断,尽早诊断及时治疗,以避免并发胆管癌的发生提高其治疗效果。
Objective To study the relationship between hepatolithiasis and cholangiocarcinoma and to summarize the diagnosis and treatment of hepatolithiasis with cholangiocarcinoma. Methods From February 2000 to September 2012 to our hospital for pathological diagnosis of intrahepatic bile duct stones in a total of 490 patients, including a total of 18 patients with cholangiocarcinoma, 18 cases of clinical data were retrospectively analyzed . Results In 490 cases of intrahepatic bile duct stones, 3.7% of patients with cholangiocarcinoma, 18 cases in total. Among them, 34.2% of cholangiocarcinoma, 41.0% of hilar cholangiocarcinoma; 18.0% of extrahepatic cholangiocarcinoma; and 6.8% of ampullary carcinoma. The 18 cases of cholangiocarcinoma patients underwent surgery, the correct diagnosis rate was 22.2%, 4 cases; 27.8% of patients with intraoperative resection of the diseased cells radical excision, a total of 5 cases, and the results of poor treatment after 1 The annual survival rate was 25.7%, 2-year survival rate was only 14.3%. Conclusions Research and analysis found that among the patients with cholangiocarcinoma and cholangiocarcinoma, the prevalence rate is over 45 years old. Therefore, in the clinical diagnosis, patients over 45 years of age with hepatolithiasis more than 10 years experience weight loss and abdominal pain Not easy to alleviate and other issues of patients, should be its appropriate diagnosis, diagnosis and timely treatment in order to avoid the occurrence of concurrent cholangiocarcinoma to improve its therapeutic effect.