关键词: 胆囊癌, 围肝门外科技术, 第一肝门, 顺逆结合肝门解剖, 数字医学

Abstract:

Application of perihilar surgical techniques in gallbladder cancer invading hepatic hilum        WANG Wei, WANG Jian. Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127,China
Corresponding author: WANG Jian, E-mail: dr_wangjian@126.com
Abstract    Gallbladder cancer invading hepatic hilum has both the biological characteristics of gallbladder cancer and the clinical features of hilar cholangiocarcinoma. There are a series of therapeutic difficulties such as difficult exposure of hepatic hilum, multiple organ resection, resection and reconstruction of hilar vessels, complex cholangiojejunostomy and liver functional restriction, which result in low radical resection rate, difficulty in operation, high operative risk, more postoperative complications and perioperative mortality. The perihiliar surgical technique system adopts accurate preoperative three-dimensional imaging evaluation and liver function evaluation, and completely exposes hepatic hilum via combining anterograde and retrograde route from extra and intra-hepatic direction to hepatic hilum, which is beneficial to intraoperative re-evaluation. It can improve the R0 resection rate, quality of vascular resection and reconstruction, quality of cholangiojejunostomy, and reduce perioperative morbidity and mortality. Surgeons should pay attention to the combination of perihiliar surgical technique and oncology in order to screen which patients will benefit from operation.

Key words: gallbladder cancer, perihilar surgical technique, first porta hepatis, combining anterograde and retrograde route exposing hepatic hilum, digital medicine