开展局部进展期胆囊癌根治术的理性思考原则  

Principles for radical surgery of locally advanced gallbladder cancer

作　　者：洪德飞[1] HONG De-fei(Department of General Surgery,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院普外科,浙江杭州310016

出　　处：《中国实用外科杂志》2023年第11期1241-1244,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金面上项目(No.82172599);浙江省科学技术厅省级重点研发计划项目(No.2020C03024)。

摘　　要：对局部进展期胆囊癌积极实施开放根治性切除和扩大切除的传统观念不断受到靶向和免疫治疗联合化疗以及腹腔镜胆囊癌根治术的挑战。基于肿瘤个体化生物学特性和主诊医师制定的治疗决策决定病人预后,针对实施局部进展期胆囊癌根治术提出3个理性原则:基于肿瘤生物学为王理念,理性选择手术适应证;基于加速康复外科和肿瘤综合治疗理念,理性选择根治性切除范围;基于预后和卫生经济学理念,理性选择腹腔镜手术和机器人辅助手术。Traditional radical open surgery and extended resection for locally advanced gallbladder cancer have always been challenged by target immunotherapy combined chemotherapy and laparoscopic surgery.Since individual biological characteristics and treatment strategy decided by a chief physician are prognosis determinant factors,the author claimed three rational principles for the radical surgery of locally advanced gallbladder cancer:Rational selection of radical surgery indication based on the key importance of tumor biology;Rational selection of resection range based on enhanced recovery and comprehensive therapy;Rational choice of laparoscopic surgery or robot-assisted surgery based on seeking for better prognosis and reasonable economic expenses.

关 键 词：胆囊癌 根治性切除术 综合治疗 原则 

分 类 号：R6[医药卫生—外科学]