Cavallaro Andrea, Cavallaro Vincenzo, Di Vita Maria, Cappellani Alessandro
Department of Surgical Sciences, Organs Trasplants, Advanced Technologies-Azienda Policlinico "Gaspare Rodolico", University of Catania, Italy.
Ann Ital Chir. 2009 Mar-Apr;80(2):107-11.
Cholangiocarcinoma (CC) is rare malignant tumors arising from cells of the biliary tract. It presents some difficulties to diagnose, and is associated with a high mortality. Traditionally extrahepatic CC is divided into klatskin tumors, intermediate tract and distal or iuxtapapillar tumors according to its location within the biliary tree. CT RM, PET may provide useful diagnostic information in those patients. Surgical resection is the only chance for cure, with results depending on selected patients and careful surgical technique. Liver transplantation could offer long-term survival in selected patients when combined with chemotherapy. Chemotherapy, radiation therapy, and external drainage remain as the only treatment for inoperable patients.
The authors report their experience since 1997 inherent to 38 cases of extrahepatic CC, 21 of which were treated by surgery: their outcome has been evaluated.
Surprisingly four of them (2 with intermediate tract tumor and 2 with distal tract tumors) are still alive and apparently disease-free after 5 years since surgery. Moreover another one patient with papillar tumor has reached 5 years survival despite has undergone surgery two times.
Surgery remains the best chance for long-term survival, and lymph node status is the most important prognostic factor following R0 resection.
胆管癌（CC）是起源于胆管细胞的罕见恶性肿瘤。其诊断存在一些困难，且死亡率较高。传统上，肝外胆管癌根据其在胆管树中的位置分为肝门部肿瘤、中段肿瘤和远端或壶腹周围肿瘤。CT、磁共振成像（RM）、正电子发射断层显像（PET）可为这些患者提供有用的诊断信息。手术切除是治愈的唯一机会，其结果取决于所选患者和精细的手术技巧。肝移植联合化疗可为部分患者提供长期生存机会。化疗、放疗和外引流仍是无法手术患者的唯一治疗方法。
作者报告了自1997年以来38例肝外胆管癌患者的治疗经验，其中21例接受了手术治疗，并对其治疗结果进行了评估。
令人惊讶的是，其中4例（2例中段肿瘤和2例远端肿瘤）自手术5年后仍存活且显然无疾病。此外，另1例壶腹肿瘤患者尽管接受了两次手术，但已存活5年。
手术仍然是长期生存的最佳机会，淋巴结状态是R0切除术后最重要的预后因素。
