中文摘要：

目的回顾性总结胆管细胞癌胆肠吻合术后肝内转移灶经微波消融后的并发症和预后。方法2008年2月至2011年10月，解放军总医院6例患者肝内10个转移性胆管细胞癌经微波消融治疗，患者男5例、女1例，年龄52～63（58±6）岁，肿瘤大小1．5～3．6（3．3±1．3）em。所有患者原发病变均位于肝外并曾行手术切除和胆肠吻合术，其中4例患者微波消融前有肝内胆管扩张和积气。结果所有10个转移灶均完全消融，其中4例患者的5个消融灶术后发生脓肿（5／10），并有窦道形成。3例患者经抗炎、置管引流和对症支持治疗后治愈，1例患者术后13d死亡。随访期内（13d～37个月）1、2、3年生存率分别为64．8％、21．6％、21．0％（中位生存期，15．7个月）。结论微波消融胆肠吻合术后肝内转移性胆管细胞癌具有很高的技术有效率，但肝脓肿的发生率很高，明确原因有利于预防和发生后的及时处置。

英文摘要：

Objective To explore the complications and clinical outcome of liver metastatic cholangiocarcinoma after microwave ablation （MWA） liver resection with bilioenteric anastomosis. Methods in patients with a history of pancreatoduodenectomy or Retrospective study was made on 10 lesions of intra- hepatic metastatic cholangiocarcinoma undergoing MWA （ range ： 1.5 - 3.6 cm, mean： 3.3 ± 1.3 cm ） in 6 patients （5 males and 1 female） from February 2008 to October 2011. All had a history of surgical resection for primary neoplasm and bilioenteric anastomosis. Four cases had intrahepatic biliary dilatation pneumatosis. Results All lesions were completely ablated according to the results of contrast-enhanced ultrasound （CEUS） or contrast-enhanced computed tomography/magnetic resonance imaging （CT/MRI） at Month 1 post-MWA. Liver abscess and fistula occurred in 5 ablation zones （5/10） of 4 patients. Three cases were satisfactorily cured with antibiotic dosing, catheter drainage and supportive care. One case died 13 days after MWA. The overall 1, 2, 3-year survival rates of were 64. 8%, 21.6% and 21.0% respectively （median：15.7 months）. Conclusion A high technical success rate of MWA is obtained in the treatment of intrahepatie metastatic cholangiocarcinoma with bilioenteric anastomosis. However, the incidence of abscess formation remains high due to a coexistence of multiple risk factors.