肝细胞癌伴胆管癌栓诊治进展  

Progress on diagnosis and treatment of hepatocellular carcinoma associated with bile duct tumor thrombus

作　　者：冯锦凯 陈振华 武宇轩 程树群 FENG Jin-kai;CHEN Zhen-hua;WU Yu-xuan(Department of Hepatic Surgery VI,Eastern Hepatobiliary Surgery Hospital,Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学东方肝胆外科医院肝外六科,上海200433 [2]海军军医大学基础医学院,上海200433

出　　处：《中国实用外科杂志》2020年第10期1210-1213,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金重点项目(No.81730097)。

摘　　要：肝细胞癌可侵犯肝内外胆管形成胆管癌栓,其易与胆总管结石、胆管癌等疾病相混淆。目前,肝细胞癌合并胆管癌栓的诊断及鉴别诊断主要依靠超声、CT、磁共振等影像学检查。在肝细胞癌伴胆管癌栓治疗方面,外科手术切除已成为主要治疗方式。尽管有文献报道肝细胞癌伴胆管癌栓的病人在接受根治性手术后能达到与不伴癌栓的病人相似的生存结局,但总体上此类病人的预后仍不良。手术治疗与胆管引流、经动脉化疗栓塞、射频消融等非手术疗法的综合应用或能提高此类病人的远期预后,在肝细胞癌伴胆管癌栓的治疗中具有良好应用前景。Hepatocellular carcinoma(HCC)can invade intraand extrahepatic biliary tract to form bile duct tumor thrombus(BDTT),which is easy to be misdiagnosed as choledocholithiasis,cholangiocarcinoma and so on.Currently,the diagnosis and differential diagnosis of HCC with BDTT mainly depend on imaging modalities,including ultrasonography,computed tomography and magnetic resonance imaging.In terms of the therapeutic choices of HCC with BDTT,surgical resection has become the mainstay of treatment options.The overall prognosis of the patients is still dismal,although sporadic studies reported HCC patients with BDTT could reach similar survival outcomes after curative operation compared to those without BDTT.It is promising to combine surgical treatments with non-surgical therapeutic modalities such as biliary drainage,transarterial chemoembolization and radiofrequency ablation in the treatment of HCC with BDTT,which may elevate the longterm prognosis of such patients.

关 键 词：肝细胞癌 胆管癌栓 手术切除 经动脉化疗栓塞 射频消融 

分 类 号：R6[医药卫生—外科学]