【摘要】 １９９０年以来开展肝门部胆管癌骨骼化切除及肝中央部分切除１６例，切除率为２８．５％。肿瘤切除后行肝管空肠吻合．吻合口留置硅胶内支架管。切除标本送光镜及ＣＥＡ免疫组化表达。胆汁送ＣＥＡ检测和肝吸虫卵检查。病理学诊断高分化腺癌８例（５０％）．低分化腺癌７例（４５％）．腺癌样增生恶变１例（５％）。胆汁和切片中发现肝吸虫５例（３１％）、胆汁ＣＥＡ检测平均８１±１０．６ｎｇ·Ｌ－１均高于正常。ＣＥＡ免疫组化表达均阳性．高分化腺癌以膜型标记为主．低分化腺癌呈弥漫型标记。淋巴结转移阳性３例（１９％），周围神经束浸润４例（２５％）。术后随访３ｍｏｎ至３．５ａ．生存期最长２例已达３．５ａ．目前仍生存．最短３５ｄ．平均生存期２０．３ｍｏｎ。更多还原

【Abstract】 Abstract Since 1990, skeletonization resection combined with central hepatic resectionhad been Performed in 16 cases with hilarcholangiocarcinoma. Resectable rate was28.5% (16/56).After resection,the anastomoses between hepatic duct stomata and Rouxen-Y jeiunal loop were performed withtransanastomotic silicon stent.Tumor specimens of 16 cases were got forhistologic study and immunohistochemistry ofcarcinoembryonic antigen(CEA). Bile of patientis were available for CEA test and clonorchiasis examination.The results of 16 cases of clinicopathologicstudy and clinical follow-up showed poorly differentiated adenocarcinoma in 7 cases(45%),well differentiation in & cases (50%),malignant adenomatoid hyperplasia in 1 cases (5% ),and clonorchiasis eggs in bile and specimens in 5cases (31 % ). CEA of bile was clearly elevatedin 16 cases,with a mean of 81±10. 6 ng. L-1(normal<15ng. L-1). Immunohistochemistryof CEA was in 100% positive demonstration andlymph node metastasis was in 3 cases (19%).Perineural invasion was in 4 cases(25%).Postoparative follow-up was made in 16 caseswith average survival of 20. 3 months. Thelongest survival was 42 months in 2 cases, whoare alive up to now.更多还原