《肿瘤外科学年鉴:肝外胆管癌和胆囊癌临床诊疗指南》推荐意见  

Recommendations from Annals of Surgical Oncology:Clinical guidelines for extrahepatic cholangiocarcinoma and gallbladder carcinoma

作　　者：郭伟 李鑫 王明达 杨田 GUO Wei;LI Xin;WANG Mingda;YANG Tian(Department of General Surgery,The First Affiliated Hospital of Henan University,Kaifeng,Henan 475001,China;Department of Hepatic Surgery,Third Affiliated Hospital of Naval Medical University(Eastern Hepatobiliary Surgery Hospital of Shanghai),Shanghai 200438,China)

机构地区：[1]河南大学第一附属医院普通外科,河南开封475001 [2]海军军医大学第三附属医院(上海东方肝胆外科医院)肝脏外科,上海200438

出　　处：《临床肝胆病杂志》2024年第4期682-687,共6页Journal of Clinical Hepatology

基　　金：国家自然科学基金项目(81972726);上海市自然科学基金项目(22ZR1477900);河南省医学科技攻关计划项目(LHGJ20190512)。

摘　　要：胆道恶性肿瘤是一类发病率低但侵袭性强的消化道肿瘤,主要包括肝内胆管癌、肝外胆管癌和胆囊癌,常常伴随着局部进展或远处转移等特征。对于局部可切除的患者而言,手术往往是首选的治疗方法。然而,即便患者接受根治性手术其术后复发风险依然很高。因此,对于胆道恶性肿瘤患者而言,通常需要采取多种治疗模式,包括手术切除、全身治疗(如靶向治疗、化学治疗、免疫治疗)以及/或局部治疗的综合方案。随着胆道恶性肿瘤领域的逐渐发展,对于外科肿瘤学家而言,了解并掌握最新的外科诊疗策略以及最佳患者的选择和管理体系至关重要。鉴于治疗的复杂性和诊疗技术不断发展的特点,美国肿瘤外科学权威期刊《肿瘤外科学年鉴》于近期发表了关于肝胆肿瘤的实践诊疗指南,主要包括肝细胞癌、肝内胆管癌、肝外胆管癌和胆囊癌,旨在为肝胆肿瘤患者的临床管理和决策制定提供更多基于循证医学的证据。限于篇幅和不同侧重点,本文着重介绍该指南中关于肝外胆管癌和胆囊癌的评估要点和临床治疗的相关建议,以供临床参考。Biliary tract carcinoma(BTC)is a type of gastrointestinal tumor with a low incidence rate and a strong invasive ability,mainly including intrahepatic cholangiocarcinoma(ICC),extrahepatic cholangiocarcinoma(ECC),and gallbladder carcinoma(GC),often accompanied by local progression or distant metastasis.Surgery is often the preferred treatment method for patients with local resectable tumor;however,there is still a high risk of recurrence after radical surgery.Therefore,multiple treatment modalities are often required for BTC patients,including surgical resection,systemic treatment(such as targeted therapy,chemotherapy,and immunotherapy),and/or a combination of local treatment methods.With the development of the field of BTC,it is critical for surgical oncologists to understand and master the latest surgical strategies and the best patient selection and management systems.In view of the complexity of treatment and the continuous development of diagnosis and treatment techniques,Annals of Surgical Oncology,an authoritative American journal of cancer surgery,recently published the practical diagnosis and treatment guidelines for hepatobiliary tumors,including hepatocellular carcinoma(HCC),ICC,ECC,and GC,aiming to provide more evidence-based evidence for the clinical management and decision-making of patients with hepatobiliary tumors.Due to the limitations of length and different emphases,this article mainly introduces the recommendations for the evaluation points and clinical treatment of ECC and GC in the guidelines,so as to provide a reference for clinical practice.

关 键 词：胆管上皮癌 胆囊肿瘤 诊断 外科手术 围手术期 

分 类 号：R735.8[医药卫生—肿瘤]