【摘要】 目的 探討老年肝門膽管癌的圍手術期處理方法。 方法 回顧性分析1992年6月-2004年10月收治的60歲以上的肝門膽管癌患者臨床資料。 結果 78例患者合并有多臟器儲備功能改變，施行手術切除12例，外引流手術11例，內引流手術55例。17例出現并發癥，以肺部感染、肝腎功能衰竭和吻合口瘺為多見。根治性切除、 姑息性切除和姑息性引流組手術后中位生存時間分別為12、8、5個月。 結論 肝門膽管癌的手術復雜，創傷大，對老年患者更容易產生心肺功能異常及各種并發癥；但通過圍手術期內合理、充分的綜合治療措施，仍能取得較好的治療效果。【Abstract】 Objective To investigate the perioperative therapy for the elder patients with hilar cholangiocarcinoma. Methods The clinical data of over 60 years old patients with hilar cholangiocarcinoma who were treated in the hospital from June 1992 to October 2004 were retrospectively analyzed. Result Seventy-eight patients with multiple organs liver functional changes, 12 patients received surgical excision, 11 patients received external drainage surgery, 55 patients received internal drainage surgery. Postoperative complications occurred in 17 patients, wost of which were lung infection, liver and kidney failure and anastomotic leakage. The median survival time were 12, eight and five months for the patients who received radical resection, palliative resection and drainage, respectively. Conclusions The surgical treatment for hilar cholangiocarcinoma is complicated with major surgical trauma. The postoperative complication and the cardio-pulmonary dysfunetion are easily happened especially in the aged patients. Intensive supportive therapy is needed all over the course.
