Clinical Study of Cholangiocarcinoma
摘要
The clinical manifestations of cholangiocarcinoma of 32 patients in a 8-year period were analysed There were 19 males and 13 females (the ratio was 1. 5:1). The mean age was 55-9 years (range: 35-76 years). They were divided into the hilar type (14 cases) and the peripheral type (18 cases) according to their locations. The hilar type frequently presented with jaundice (86%), whereas the peripheral type manifested with hepatomegaly (61%) and epigastralgia (56%). Elevated serum bilirubin, alkaline phosphatase, and γ-glutamyltransferase were usually noted biochemically. Determined by radioimmunoassay, 70% had elevated serum levels of carcinoembryonic antigen, 16% had elevated serum levels of a-fetoprotein, and 21% were HBsAg carriers. Biliary calculi were found in 13 patients (41%), The coexistence of cholangiocarcinoma and biliary calculi was more frequently found in the peripheral type (50%) than in the hilar type (29%). Ultrasonography was usually used as the first-line investigating tool, but in the hilar type, direct cholangiography was indispensable. The resectability rate was 33.3% (6/18) for the peripheral type, and 7.1% (1/14) for the hilar type. Chemotherapy and transcatheter arterial embolization were alternatives for peripheral tumors; bypass surgery and percutaneous transhepatic cholangio-drainage were used for hilar tumors. The prognosis was dismal. The mean survival time was 5.5 months in the peripheral type and 3.9 months in the hilar type.