【摘要】 目的 探讨肝内胆管结石并发肝胆管癌的诊断和治疗。方法 回顾性分析1994年1月～2004年12月我院14例肝内胆管结石并发肝胆管癌患者的临床资料，并对其诊断、治疗和预后进行总结。结果 14例肝胆管癌的发生率占同期肝内胆管结石患者的2.1%(14/660)，均经手术治疗；术前诊断率为42.9%(6/14)，术中诊断率为100%；根治性手术率28.6%(4/14)，获随访4例，平均生存18个月；姑息性手术率71.4%(10/14)，获随访4例，平均生存4个月。结论 必须警惕肝内胆管结石并发肝胆管癌的可能，提高肝内胆管结石并发肝胆管癌疗效的关键是早期诊断，争取根治性手术。

    【关键词】 胆管癌；胆管结石

    Hepatolithiasis associated with hepatocholangiocarcinoma

    LIN Qing, CHEN Ru-fu, ZHOU Quan-bo.

    Department of Hepatobiliary Surgery,The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120，China

    【Abstract】 Objective To analyze the diagnosis and treatment of hepatolithiasis associated with hepatocholangiocarcinoma.Methods Between 1994 and 2004, a total of 14 hepatocholangiocarcinoma patients with definite history of hepatolithiasis were treated surgically in our hospital. The diagnosis,treatment and prognosis of this clinical entity were retrospectively analyzed.Results Hepatocholangiocarcinoma occurred in 2.1% of patients with hepatolithiasis in this group. All patients underwent laparotomy, with diagnosis established preoperatively in 6(42.9%) cases and intraoperative diagnosis was missed in no case. Radical resection were performed in only 4 cases which average survival time was about 18 months. Ten cases were subjected to palliactive operations and the average survival time was about 4 months.Conclusion Hepatocholangiocarcinoma may develop in patients with a history of hepatolithiasis. The key to improve the therapeutic effectiveness is early diagnosis and striving for radical operation. ......