中国实用外科杂志

中国实用外科杂志

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肝门部胆管癌外科治疗争议与进展

李    炜1,2，王敬晗1，姜小清1   

  1. 1海军军医大学东方肝胆外科医院胆道一科，上海 200438；2上海中医药大学附属普陀医院普外科，上海 200062
  • 出版日期:2020-04-01 发布日期:2020-04-17

  • Online:2020-04-01 Published:2020-04-17

摘要： 肝门部胆管癌是指原发于胆囊管开口以上，左、右二级肝管水平以下的肝门区胆管恶性肿瘤，占所有胆道恶性肿瘤的50%~70%。肝门部胆管癌根治性手术切除率低，病人预后差，生存期短。近年来，尽管在诊断和治疗方面取得了一定进展，但在术前胆道引流、门静脉栓塞、手术切除范围选择、联合血管切除重建、微创手术治疗和肝移植治疗等方面仍存在争议。

关键词: 肝门部胆管癌, 经皮经肝胆管引流, 门静脉栓塞, 肝移植

Abstract: Controversies and advances in surgical treatment of hilar cholangiocarcinoma        LI Wei*，WANG Jing-han，JIANG Xiao-qing. *Department of Biliary Tract Surgery I，Shanghai Eastern Hepatobiliary Surgery Hospital，Shanghai 200438，China
Corresponding author：JIANG Xiao-qing，E-mail：jxq1225@
sina.com
Abstract    Hilar cholangiocarcinoma is defined as a primary tumor arising from the hilar biliary duct between the originating of the cystic duct and the second-order ducts，which accounts for 50%~70% biliary duct malignancies. Patients with HCCA have a lower radical resection rate，poorer prognosis and shorter survival period. In recent years，despite some progresses in diagnosis and treatment，there are still controversies and divergencies in the treatment of HCCA，concerning preoperative biliary drainage，portal vein embolization，the extent of surgical resection，combined vascular resection with reconstruction，minimally invasive surgery and liver transplantation.

Key words: hilar cholangiocarcinoma, percutaneous transhepatic cholangial drainage, portal vein embolization, liver transplantation