肝门部胆管癌手术切除范围的争议及诊疗进展

汪宏; 姚小晓; 乔士兴

doi:10.3969/j.issn.1001-5256.2020.03.053

肝门部胆管癌手术切除范围的争议及诊疗进展

DOI: 10.3969/j.issn.1001-5256.2020.03.053

吉林大学第二医院肝胆外科

详细信息

中图分类号: R735.8
计量
- 文章访问数: 884
- HTML全文浏览量: 25
- PDF下载量: 196
- 被引次数: 0
出版历程
- 收稿日期: 2019-10-08
- 出版日期: 2020-03-20

Controversies over the extent of surgical resection for hilar cholangiocarcinoma and research advances in diagnosis and treatment

Department of Hepatobiliary Surgery,Second Hospital,Jilin University

摘要

摘要: 肝门部胆管癌(HCCA)是肝外胆管常见的恶性肿瘤,具有解剖位置特殊、肿瘤沿胆管生长、肿瘤恶性程度高、易侵犯肝实质等特点。目前HCCA主要的治疗方式包括手术切除、非手术胆道引流、新辅助放化疗、光动力学疗法等,但手术切除仍是其首选方法。关于HCCA术前是否需要减黄和门静脉栓塞及手术切除范围一直存在争议。对HCCA的临床分型、术前检查及诊断、治疗方法的进展进行阐述。
- 胆管肿瘤 /
- 诊断 /
- 外科手术
Abstract: Hilar cholangiocarcinoma( HCCA) is a common malignant tumor of the extrahepatic bile duct and has the features of special anatomical location,tumor growth along the bile duct,high degree of malignancy,and easy involvement of liver parenchyma. At present,the treatment methods for HCCA include surgical resection,non-surgical biliary drainage,neoadjuvant chemoradiotherapy,and photodynamic therapy,but surgical resection is still the preferred method. There are still controversies over the need for preoperative biliary drainage,portal vein thrombosis,and extent of surgical resection. This article elaborates on the research advances in the clinical typing of HCCA,preoperative examination and diagnosis,and treatment methods.
- bile duct neoplasms /
- diagnosis /
- surgical procedures,operative

HTML全文

参考文献(26)

[1] CHEN XP,XIANG S. Therapy of hilar cholangiocarcinoma in the precise medicine period[J]. Chin J Dig Surg,2018,17(1):3-8.(in Chinese)陈孝平，项帅．精准医学时代肝门部胆管癌的治疗[J]．中华消化外科杂志，2018,17(1):3-8.

[2] ZHANG YP,WANG SM,HAN SZ. Research progress on combined measurement of tumor markers in the diagnosis of hilar cholangiocarcinoma[J]. China Mod Doct,2017,55(1):162-165.(in Chinese)张雁鹏，王世明，韩栓柱．肿瘤标志物联合检测在肝门胆管癌诊断和治疗中的研究进展[J]．中国现代医生，2017,55(1):162-165.

[3] WANG XQ,TANG NH,LI XJ,et al. Expression and clinical significance of DLK1 and MMP-9 in cholangiocarcinoma[J].J Clin Hepatol,2014,30(3):260-263.(in Chinese)王晓茜，唐南洪，李秀金，等．穿膜蛋白1和基质金属蛋白酶9在胆管癌中的表达及意义[J]．临床肝胆病杂志，2014,30(3):260-263.

[4] CHEN HC,LI YY. Significance of combined measurement of carcinoembryonic antigen,carbohydrate antigen 19-9,and carbohydrate antigen 50 in the diagnosis of hilar cholangiocarcinoma[J]. Shandong Med J,2008,48(32):64-65.(in Chinese)陈寒超，李玉英．CEA、CA19-9、CA50联合检测在肝门部胆管癌诊断中的意义[J]．山东医药，2008,48(32):64-65.

[5] ENDO I,MASTSUYAMA R,MORI R,et al. Imaging and surgical planning for perihilar cholangiocarcinoma[J]. J Hepatobiliary Pancreat Sci,2014,21(8):525-532.

[6] YANG SZ,DONG JH. Miscellaneous issues in the application of computer-assisted operative planning system for precise hepatectomy[J]. Natl Med J China,2010,90(28):1945-1947.(in Chinese)杨世忠，董家鸿．计算机辅助精准肝切除手术规划系统应用的若干问题[J]．中华医学杂志，2010,90(28):1945-1947.

[7] LIU YY,LIU R. Advances in the application of 18F-FDG PET/CT in the diagnosis and treatment of hilar cholangiocarcinoma[J]. Shandong Med J,2017,57(16):111-113.(in Chinese)宋昱垚，刘荣．18F-FDG PET/CT在肝门部胆管癌诊治中的应用进展[J]．山东医药，2017,57(16):111-113.

[8] ZHANG B,WU ZY. Preoperative biliary drainage for hilar cholangiocarcinoma[J]. Dig Surg,2006,5(6):471-474.(in Chinese)张斌，吴志勇．肝门部胆管癌的术前胆道引流[J]．消化外科，2006,5(6):471-474.

[9] ZHANG H,ZHANG Z,ZHANG HT,et al. Comparison of clinical effects about hilar cholangiocarcinoma operation of patients after preoperative biliary drainage by ENBD and PTCD[J]. J Abdominal Surg,2017,30(3):197-201.(in Chinese)张辉，张振，张海涛，等．肝门部胆管癌根治术前经内镜鼻胆管引流和经皮经肝胆管造影引流术的临床效果观察[J]．腹部外科，2017,30(3):197-201

[10] ITO F,CHO CS,RIKKERS LF,et al. Hilar cholangiocarcinoma:Current management[J]. Ann Surg,2009,250(2):210-218.

[11] XIANG CH,YAO L,LI QD,et al. Percutaneous transhepatic portal embolization for hilar cholangiocarcinoma[J]. Chin J Min Inv Surg,2007,7(1):441-446.(in Chinese)项灿宏，姚力，李启东，等．经皮经肝门静脉栓塞术在肝门部胆管癌手术中的应用[J]．中国微创外科杂志，2007,7(1):441-446.

[12] WANG S,YE GX,WANG Y,et al. The related research of hilar cholangiocarcinoma in the preoperative preparation[J].China Mod Doct,2013,51(35):11-13.(in Chinese)王世，叶冠雄，王钰，等．肝门部胆管癌的术前准备相关研究进展[J]．中国现代医生，2013,51(35):11-13.

[13] PALAVECINO M,ABDALLA EK,MADOFF DC,et al. Portal vein emboliza-ion in hilar cholangiocarcinoma[J]. Surg Oncol Clin N Am,2009,18(2):257-267.

[14] HEMMING AW,REED AI,FUJITA S,et al. Surgical management of hilar cholangiocarcinoma[J]. Ann Surg,2005,241(5):693-699,discussion 699-702.

[15] SAKAMOTO E,NIMURA Y,HAYAKAWA N,et al. The pattern of infiltration at the proximal border of hilar bile duct carcinoma:A histologic analysis of 62 resected cases[J]. Ann Surg,1998,227(3):405-411.

[16] CHO MS,KIM SH,PARK SW,et al. Surgical outcomes and predicting factors of curative resection in patients with hilar cholangiocarcinoma:10-year singleinstitution experience[J]. J Gastrointest Surg,2012,16:1672-1679.

[17] LIM JH,CHOI GH,CHOI SH,et al. Liver resection for bismuth type I and type II hilar cholangiocarcinoma[J]. World J Surg,2013,37(4):829-837.

[18] CHEN XP,LAU WY,HUANG ZY,et al. Extent of liver resection for hilar cholangiocarcinoma[J]. Br J Surg,2009,96(10):1167-1175.

[19] KAWASAKI S,IMAMURA H,KOBAYASHI A,et al. Results of surgical resection for patients with hilar bile duct cancer:Application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization[J]. Ann Surg,2003,238(1):84-92.

[20] FARGES O,REGIMBESU JM,FUKS D,et al. Multicentre European study of preoperative biliary drainage for hilar cholangiocarcinoma[J]. Br J Surg,2013,100(2):274-283.

[21] de JONG MC,MARQUES H,CLARY BM,et al. The impact of portal vein resection on outcomes for hilar cholangiocarcinoma:A multi-institutional analysis of 305 cases[J]. Cancer,2012,118:4737-4747.

[22] ABBAS S,SANDROUSSI C. Systematic reviewand metaanalysis of the role of vascular resection in the treatment of hilar cholangio-carcinoma[J]. HPB(Oxford),2013,15(7):492-503.

[23] ZHANG X,WANG YD,CAI JP,et al. Umbrella tube drainage and 125I particles in radiotherapy for advanced hilar cholangiocarcinoma[J]. J Pract Med,2015,31(3):449-451.

[24] HONG JC,JONES CM,DUFFY JP,et al. Comparative analysis of resectionand liver transplantation for intrahepatic and hilar cholangiocarcinoma:A 24-year experience in a single center[J]. Arch Surg,2011,146(6):683-689.

[25] MA XP,HONG J,AN CP,et al. Acupuncture-moxibustion in treating irritable bowel syndrome:How does it work[J]. World J Gastroenterol,2014,20(20):6044-6054.

[26] GRASSIAN AR,PAGLIARINI R,CHIANG DY. Mutations of isocitrate dehydrogenase I and 2 inintrahepatic cholangiocarcinoma[J]. Curr Opin Gastroenterol,2014,30:295-302.

施引文献

资源附件(0)

访问统计