胆管细胞癌——尾状叶切除术和肝中叶切除术的作用。
Cholangiocellular carcinoma--the role of caudate lobe resection and mesohepatectomy.
机构信息
Department of General, Viceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
出版信息
HPB (Oxford). 2008;10(3):179-82. doi: 10.1080/13651820801992500.
BACKGROUND
The surgical treatment of perihilar cholangiocellular carcinoma (CCC) is challenging due to the adjacency of the tumor to the hilar vessels, major hepatic veins, bile ducts, and the inferior vena cava. Additionally, the tumour frequently infiltrates the parenchyma of the caudate lobe or/and invades its bile ducts.
CONSENSUS STATEMENTS
Negative margin caudate hepatectomy is rarely feasible. Isolated partial or complete caudate lobe resection is an oncologically inadequate procedure. Extended hepatectomies in combination with caudate lobectomy can provide prolonged survival, even in patients with advanced CCC. Mesohepatectomy is an oncologically adequate procedure for selected patients with CCC and compromised liver function. The procedure is technically demanding; however, it lowers the risk of postoperative liver failure.
背景
由于肿瘤毗邻肝门血管、肝静脉主干、胆管和下腔静脉，肝门部胆管细胞癌（CCC）的外科治疗极具挑战性。此外，肿瘤常浸润尾状叶实质或/和侵犯其胆管。
共识声明
阴性切缘的尾状叶肝切除术很少可行。孤立的部分或完全尾状叶切除术是一种肿瘤学上不充分的手术。联合尾状叶切除的扩大肝切除术可为晚期 CCC 患者提供更长的生存时间。对于肝功能受损的特定 CCC 患者，中肝切除术是一种肿瘤学上充分的手术。该手术技术要求较高，但可降低术后肝功能衰竭的风险。
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