关键词: 外科, 胆道外科, 微创外科

Abstract:

Present status of biliary surgery in the era of minimally invasive surgery        HUANG  Zhi-qiang. Research Institute of Hepatobiliary Surgery of PLA，General Hospital of  PLA,Beijing100853，China
Abstract    Since the first case of cholecystectomy conducted under laparoscopy, the technique of biliary surgery has been revolutionized. At the present time, more and more formerly standard surgical procedures had been taken over by laparoscopic method. However, laparoscopic cholecystectomy is still not a procedure without risks. The advances in imaging technology such as virtual reality and 3D reconstruction image of the intra- and extra-hepatic structures may be helpful in the preoperative evaluation and planning of the complicated operative procedures in cases of hepatolihiasis as well as in other intrahepatic leisons. Intrahepatic cholangiocarcinoma, accounted for 5%-10% of the primary hepatic cancer, is a kind of malignancy with distinct patho-biological behavior different from that of hepatic cell carcinoma and should be considered differently from hepatic cell carcinoma as to the treatment of option, extended radical resection instead of local resection or ablation should be adapted as the rule. As to the surgical treatment of hilar cholangiocarcinoma, extended liver resection improved the result in the early, nodal negative patients. At present, many traditional surgical operations will be scrutinized according to the present-day surgical theme of minimal invasiveness.

Key words: surgery, biliary surgery, minimally invasive surgery