Stain S C, Baer H U, Dennison A R, Blumgart L H
Clinic for Visceral and Transplantation Surgery, University of Berne, Switzerland.
Surg Gynecol Obstet. 1992 Dec;175(6):579-88.
The goal in the treatment of hilar cholangiocarcinoma is the relief of biliary obstruction with the quality survival. The choice of therapy for an individual patient requires complete preoperative staging to determine the resectability. This is best accomplished in a multidisciplinary setting with radiologists, gastroenterologists and surgeons participating in the diagnostic and therapeutic strategies. Operative removal of the tumor can be performed with low mortality and, when possible, provides the longest palliation and offers potential for cure. For tumors found at operation to be unresectable, biliary enteric bypass provides a durable method of palliation. The relative merits of the newer methods of radiologic stenting are encouraging, but further study will require prospective trials in comparison to operative biliary enteric bypass.
肝门部胆管癌的治疗目标是在保证生存质量的前提下缓解胆道梗阻。对于个体患者的治疗选择需要进行完整的术前分期以确定肿瘤是否可切除。这最好在多学科环境中完成，由放射科医生、胃肠病学家和外科医生共同参与诊断和治疗策略。手术切除肿瘤的死亡率较低，并且在可能的情况下，能提供最长时间的缓解，并具有治愈的潜力。对于术中发现不可切除的肿瘤，胆肠吻合术是一种持久的姑息治疗方法。放射学支架置入等新方法的相对优点令人鼓舞，但与手术胆肠吻合术相比，进一步的研究需要进行前瞻性试验。
