[1]朱鸿超,匡天佐,张福扬,等.全腹腔镜Bismuth I型肝门部胆管癌根治术7例[J].中国微创外科杂志,2018,18(3):274-288.
　Zhu Hongchao,Kuang Tianzuo,Zhang Fuyang,et al.Total Laparoscopic Bismuth Type Ⅰ Radical Resection of Hilar Cholangiocarcinoma: a Report of 7 Cases[J].Chinese Journal of Minimally Invasive Surgery,2018,18(3):274-288.
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全腹腔镜Bismuth I型肝门部胆管癌根治术7例()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年3期
页码:
274-288
栏目:
经验交流
出版日期:
2018-05-01

文章信息/Info

Title:
Total Laparoscopic Bismuth Type Ⅰ Radical Resection of Hilar Cholangiocarcinoma: a Report of 7 Cases
作者:
朱鸿超; 匡天佐; 张福扬; 胡昌昌; 周龙飞; 黄明文**
南昌大学第二附属医院肝胆外科，南昌330006
Author(s):
Zhu Hongchao;  Kuang Tianzuo;  Zhang Fuyang;  et al.
Department of Hepatobiliary Surgery, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
关键词:
肝门部胆管癌; Bismuth Ⅰ型; 腹腔镜; 根治术
Keywords:
Hilar cholangiocarcinoma; Bismuth type Ⅰ; Laparoscopy; Radical resection
文献标志码:
B
摘要:
目的探讨全腹腔镜下Bismuth Ⅰ型肝门部胆管癌根治术的安全性、可行性。方法回顾性分析2011年1月~2016年1月7例全腹腔镜下Bismuth Ⅰ型肝门部胆管癌根治术的资料，全腹腔镜下肝外胆道切除，胆道重建，清扫第8、9、12、13组淋巴结。结果7例手术均顺利完成。手术时间3.5~5 h，（4.13±0.53）h；术中出血量85~250 ml，（156.4±676）ml。无胆漏、腹腔感染、术后出血等并发症。术后住院时间9~14 d，（10.7±2.0）d。术后病理均提示胆管中分化腺癌，胆管上下切缘阴性，R0切除，清扫淋巴结7~15枚，平均9.3枚，均未见癌转移。术后随访12~18个月，影像学检查均未见肿瘤复发，血癌胚抗原（CEA）和CA199正常。结论术者熟练掌握全腹腔镜下消化道重建及淋巴结清扫等的情况下，全腹腔镜下Bismuth Ⅰ型肝门部胆管癌根治术是安全、可行的。
Abstract:
ObjectiveTo explore the safety and feasibility of total laparoscopic Bismuth type Ⅰ radical resection of hilar cholangiocarcinoma.MethodsFrom January 2011 to January 2016, a total of 7 patients with hilar cholangiocarcinoma received total laparoscopic Bismuth type Ⅰ radical resection of hilar cholangiocarcinoma. Their clinical data were analyzed retrospectively. The total laparoscopic extrahepatic biliary resection was carried out, with biliary tract reconstruction and dissection of the 8, 9, 12, and 13 groups of lymph nodes.ResultsThe operation was successfully carried out in all the 7 cases. The operation time was 3.5-5 h (mean, 4.13±0.53 h). The blood loss was 85-250 ml (mean, 156.4±67.6 ml). No postoperative complications of biliary leakage, abdominal infection, or bleeding occurred. The time of hospital stay was 9-14 d (mean, 10.7±2.0 d). The results of postoperative pathological examinations showed moderately differentiated adenocarcinoma. The resection margins of bile ducts were negative, achieving a R0 resection. A total of 7-15 lymph nodes were collected (mean, 9.3), and no metastasis was found. The postoperative followup for 12-18 months with radiographic examinations showed no obvious tumor recurrence, as well as tumor makers carcinoembryonic antigen (CEA) and CA199 being normal.ConclusionIt is safe and feasible to complete laparoscopic Bismuth Ⅰ hilar cholangiocarcinoma radical operation on the basis of skillful performance of laparoscopic digestive tract reconstruction and lymph node dissection.

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备注/Memo

备注/Memo:
基金项目：江西省自然科学基金（20142BAB205108）**通讯作者，E-mail：hmw92005@163.com
更新日期/Last Update: 2018-05-10