肝门部胆管癌的临床研究进展  

Clinical research progress of the hilar cholangiocarcinoma

作　　者：张育诚 车斯尧 ZHANG Yucheng;CHE Siyao(The First Clinical Medical College,Guangdong Medical University,Zhanjiang 524023,China;Hepatobiliary Surgery,Gaozhou Hospital Affiliated to Guangdong Medical University,Maoming 525200,China)

机构地区：[1]广东医科大学第一临床医学院,广东湛江524023 [2]广东医科大学附属高州医院肝胆外科,广东茂名525200

出　　处：《中国肿瘤外科杂志》2024年第5期514-520,共7页Chinese Journal of Surgical Oncology

基　　金：茂名市科技计划项目(2021KJZXZJYX009)。

摘　　要：肝门部胆管癌(HCCA)是胆道系统中一种常见的恶性肿瘤,约占胆管癌的56%~67%。由于HCCA起病隐匿,早期症状不明显,一经发现多处于中晚期,加上其复杂的解剖结构、浸润性生长的特性以及与周围血管之间的紧密联系,为术前评估和后续的治疗增加了不小的难度,导致患者总生存率低,预后差。因此,HCCA已成为肝胆外科研究和治疗领域的重点和难点。近年来,随着临床诊疗技术的不断发展,譬如术前采用多种影像学途径明确诊断、术前胆道引流减黄、手术方式的合理选择等,有效地改善了HCCA患者的长期生存情况。笔者梳理国内外肝门部胆管癌最新的专家共识及相关的研究进展,就术前评估、手术技术和辅助治疗方面作一综述。Hilar cholangiocarcinoma(HCCA)is a common malignant tumor in the biliary system,accounting for about 56%-67%of cholangiocarcinomas.Due to the insidious onset and nonspecific early symptoms of HCCA,it is mostly found in the middle or late stage.In addition,its complex anatomical structure,infiltrative growth,and close connection with the surrounding blood vessels increase the difficulty of preoperative evaluation and subsequent treatment,resulting in a low overall survival rate and poor prognosis.Therefore,hepatoportal cholangiocarcinoma has become the focus of research and treatment in the field of hepatobiliary surgery.In recent years,with the continuous development of clinical diagnosis and treatment technology,such as using various imaging methods to make a clear diagnosis before operation,reducing jaundice of biliary drainage before operation,and reasonable selection of operation methods,the long-term survival of HCCA patients has been effectively improved.This article reviews the latest expert consensus and related research progress on hilar cholangiocarcinoma both domesticcally and internationally,providing a overview of preoperative evaluation,surgical techniques,and adjuvant therapy.

关 键 词：肝门部胆管癌 影像学检查 分型 手术方式 辅助治疗 

分 类 号：R735.8[医药卫生—肿瘤]