肝门部胆管癌外科治疗进展  

Advances in surgical treatment of hilar cholangiocarcinoma

作　　者：杨景红[1] 叶林 喻亚群[1] YANG Jinghong;YE Lin;YU Yaqun(Department of Hepatobiliary and Pancreatic Surgery,Affiliated Hospital of Guilin Medical University,Guilin,Guangxi 541001,China)

机构地区：[1]桂林医学院附属医院肝胆胰外科,广西桂林541001

出　　处：《中国普通外科杂志》2023年第8期1264-1270,共7页China Journal of General Surgery

摘　　要：肝门部胆管癌(HCCA)是指发生在左右肝管、汇合部以及肝总管上段,起源于胆管上皮细胞的一种恶性肿瘤。其发病机制的复杂性、起病症状的隐匿性、解剖结构的特殊性,使得多数患者确诊时已经处于中晚期,是当前临床诊治的难点。仅约20%的患者能得到根治性切除,R0切除率为50%~92%。术后复发率高,预后差,5年生存率仅10%~42%。目前手术切除仍是改善预后的主要有效治疗方式。随着外科各项技术进步,HCCA的外科治疗取得一定进展,但仍面临诸多挑战。笔者就HCCA的外科治疗最新的研究进展及相关争议进行以下综述。Hilar cholangiocarcinoma(HCCA)is a malignant tumor that originates from the epithelial cells of the bile ducts,occurring in the left or right hepatic duct,the hepatic duct confluence region,or the proximal segment of the common hepatic duct.Its complex pathogenesis,insidious onset of symptoms,and special anatomical location lead to most patients being diagnosed at an advanced stage,making it a challenging aspect of clinical diagnosis and treatment.Only about 20%of patients can receive radical resection,with a R0 resection rate ranging from 50%to 92%.The postoperative recurrence rate is high,and the prognosis is generally poor,with 5-year survival rates ranging from only 10%to 42%.Currently,surgical resection remains the main approach to improve the prognosis.With advancements in various surgical techniques,some progress has been made in the surgical treatment of HCCA,but it still faces numerous challenges.In this review,the authors provide an overview of the latest research progress and related controversies concerning the surgical treatment of HCCA.

关 键 词：Klatskin肿瘤/治疗 肝切除术 综述 

分 类 号：R735.8[医药卫生—肿瘤]