Ticmeanu F, Angelescu M
Chirurgia (Bucur). 2000 Jan-Feb;95(1):51-7.
The Klatskin tumor is a neoplasy of the proximate main biliary duet whose initial manifestation, and most of the time, the single one, consist in the appliance of an obstructive nature jaundice. This usually coincides with the spreading of the tumor beyond the walls of the tumors that have reached this state with a usually intraoperating made diagnosis, certain palliative technical surgery solutions could still exist. The author submits to your attention a retrospective survey on 85 tumors out of which only 3 were removable. For the remaining 82 he performed only exploratory laparotomy. Of these biopsy was made for 11 cases and palliative surgery for the other 71 (biliodigestive derivations on one or both liver lobes, or Huguet, Terblanche or Kehr tube surgery prosthesis operations). If the patient's living conditions are very good, his survival chances might be extended from 2 to 18 months, with no appearance of jaundice or pruritus. There is no doubt that if the pre-operations imagery testing results in the diagnosis "inoperable medical condition", the retrograde endoscopic transtumoral surgery prosthesis operation or the transparietal liver one, is recommended.
肝门部胆管癌是近端主要胆管的一种肿瘤,其初始表现,且大多数情况下也是唯一表现,是出现梗阻性黄疸。这通常与肿瘤扩散至超出已达此状态肿瘤的包膜同时发生,通常在术中做出诊断,此时仍可能存在某些姑息性手术技术解决方案。作者提请您注意一项对85例肿瘤的回顾性研究,其中仅有3例可切除。对于其余82例,他仅进行了剖腹探查术。其中11例进行了活检,另外71例进行了姑息性手术(对一个或两个肝叶进行胆肠吻合术,或进行Huguet、Terblanche或Kehr管手术假体操作)。如果患者的生活状况非常良好,其生存机会可能从2个月延长至18个月,且无黄疸或瘙痒出现。毫无疑问,如果术前影像学检查结果诊断为“无法手术的病情”,则推荐逆行内镜经肿瘤手术假体操作或经皮肝穿刺手术。