目的探討肝門高位切除并肝門空腸吻合術(shù)在肝門部膽管癌治療中的應(yīng)用。材料和方法 對(duì)56例術(shù)前診斷為肝門部膽管癌的病人進(jìn)行了詳細(xì)評(píng)估并進(jìn)行外科手術(shù)。術(shù)前病人均進(jìn)行了腹部超聲、強(qiáng)化CT、及（或）MRCP檢查,以確定病變的部位、侵及的范圍、血管受侵的情況、有無遠(yuǎn)處轉(zhuǎn)移等。血總膽紅素超過400 μmol/L及（或）Child分級(jí)B級(jí)以下的病人行PTCD及膽汁回輸,必要時(shí)給以腸內(nèi)或腸外營養(yǎng)。分析臨床資料,觀察肝門高位切除并肝門空腸吻合術(shù)在肝門部膽管癌治療效果。結(jié)果 51例病人行肝門高位切除并肝門空腸吻合術(shù),5例病人因腹腔內(nèi)轉(zhuǎn)移術(shù)中行穿刺置管內(nèi)引流術(shù)。術(shù)后病人血膽紅素、谷丙轉(zhuǎn)氨酶、谷草轉(zhuǎn)氨酶明顯下降。16例病人同時(shí)進(jìn)行左（或右）半肝切除,合并右肝動(dòng)脈切除11例、門靜脈部分切除4例。術(shù)后發(fā)生肝膿腫3例,1例合并膽漏的病人術(shù)后2個(gè)月死于肺部感染。其余病人隨訪三個(gè)月,基本恢復(fù)正常生活。結(jié)論 擴(kuò)大的肝門高位切除并肝門空腸吻合術(shù)是治療肝門部膽管癌有效手術(shù)方式。 

【文章來源】：山東大學(xué)山東省 211工程院校 985工程院校 教育部直屬院校

【文章頁數(shù)】：88 頁

【學(xué)位級(jí)別】：碩士

【文章目錄】：
中文摘要
ABSTRACT
LIST OF ABBREVIATIONS
CHAPTER ONE PREFACE
    1.1 Introduction
    1.2 Aim
CHAPTER TWO LITERATURE REVIEW
    2.1 Cholangiocarcinoma overview
    2.2 Epidemiology
    2.3 Aetiology
    2.4 The prevalence of iCCA, pCCA and dCCA
    2.5 Pathology
    2.6 Pathogenesis
    2.7 Classification of CCA
        2.7.1 Intrahepatic cholangiocarcinoma （iCCA）
        2.7.2 Perihilar cholangiocarcinoma （pCCA）
        2.7.3 Distal cholangiocarcinoma （dCCA）
    2.8 Diagnosis and clinical presentation
        2.8.1 iCCA subtype
        2.8.2 pCCA subtype
        2.8.3 dCCA subtype
    2.9 Management and therapy
        2.9.1 iCCA
        2.9.2 pCCA
        2.9.3 dCCA
    2.10 Cytotoxic chemotherapies
    2.11 The role of radiation therapy
    2.12 Appearance of molecular directed therapies
        2.12.1 Molecular pathogenesis
        2.12.2 Molecular targeting therapies
    2.13 Epigenetic alteration therapeutics
    2.14 Novel capable aimed therapies
    2.15 Immunotherapies for cholangiocarcinoma
        2.15.1 Immunotherapy in oncology
        2.15.2 Reasons for and risks of immunotherapy in CCA
        2.15.3 Biomarkers of candidates in response to immunotherapy
        2.15.4 Emerging clinical data on immune targeted therapies in CCA
CHAPTER THREE Methods
    3.1 Patient's Information
    3.2 Surgical Procedure
    3.3 Post-operative management
CHAPTER FOUR Results
CHAPTER FIVE DISCUSSION AND CONCLUSION
    5.1 Discussion
    5.2 Conclusion
REFERENCES
PUBLICATION
ACKNOWLEDGEMENTS
學(xué)位論文評(píng)閱及答辯情況表



本文編號(hào)：3006323