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[肝门部胆管癌的管理]

[Management of hilar cholangiocarcinoma].

作者信息

Muscari F

机构信息

Service de Chirurgie Digestive et de Transplantation Hépatique, CHU Rangueil - Toulouse, France.

出版信息

J Chir (Paris). 2007 Sep-Oct;144(5):385-92. doi: 10.1016/s0021-7697(07)73992-3.

Abstract

Hilar cholangiocarcinoma is a rare disease departing from the biliary convergence. It is primarily revealed by the onset of retention jaundice. Only 20%-30% of patients can undergo resection at diagnosis. The only chance for survival for these patients is R0 resection, which requires hepatectomy associated with resection of the common bile duct and pedicle lymph node removal, whatever the classification of the cholangiocarcinoma. No adjuvant treatment has been shown to be effective to date. Palliative treatment is most often based on implanting a biliary stent. Dynamic phototherapy may be beneficial in these situations. Improvements in survival for selected N0 hilar cholangiocarcinoma may be obtained with neoadjuvant treatment with radiochemotherapy followed by liver transplantation.

摘要

肝门部胆管癌是一种起源于胆管汇合处的罕见疾病。其主要表现为梗阻性黄疸的出现。仅20%-30%的患者在诊断时能够接受手术切除。这些患者唯一的生存机会是R0切除,无论胆管癌的分类如何,这都需要进行肝切除术并联合胆总管切除及肝门淋巴结清扫。迄今为止,尚无辅助治疗被证明有效。姑息治疗通常主要基于植入胆管支架。动态光疗在这些情况下可能有益。对于部分N0期肝门部胆管癌患者,新辅助放化疗后行肝移植可能会提高生存率。

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