Saunders K, Longmire W, Tompkins R, Chavez M, Cates J, Roslyn J
Department of Surgery, UCLA School of Medicine 90024.
Am Surg. 1991 Dec;57(12):816-20.
The majority of patients with bile duct cancer have small focal adenocarcinomas localized to the upper, middle, or lower third of the bile duct. In contrast, a small subgroup of patients have been identified with bile duct tumors that are diffuse, involving multiple segments of the extrahepatic biliary tract. Among 186 patients with documented bile duct cancer treated at the UCLA Medical Center between 1954 and 1988, 13 patients (7%) had diffuse lesions. Patients with diffuse tumors had markedly poorer survival rates than did those with focal lesions. As diffuse tumors are not amenable to resection, surgical management consists primarily of establishing suitable biliary drainage. All patients with bile duct cancer should undergo careful intraoperative evaluation to exclude a diffuse lesion before tumor resection.
大多数胆管癌患者患有局限性小腺癌，局限于胆管的上、中或下三分之一处。相比之下，已确定一小部分患者患有弥漫性胆管肿瘤，累及肝外胆管的多个节段。在1954年至1988年间于加州大学洛杉矶分校医学中心接受治疗的186例有记录的胆管癌患者中，13例（7%）有弥漫性病变。弥漫性肿瘤患者的生存率明显低于局限性病变患者。由于弥漫性肿瘤不适合切除，手术治疗主要包括建立合适的胆道引流。所有胆管癌患者在肿瘤切除前均应进行仔细的术中评估，以排除弥漫性病变。
