Tompkins R K, Aizen B M, Saunders K D, Roslyn J J, Longmire W P
Department of Surgery, UCLA Medical Center.
Am J Surg. 1991 Feb;161(2):235-8. doi: 10.1016/0002-9610(91)91137-8.
A retrospective review of patients treated for carcinoma of the common bile duct has demonstrated improvement in diagnostic capabilities, leading to earlier management by resectional therapy. The ability to resect these tumors is directly translatable to improved long-term survival. Efforts to obtain proof of malignancy prior to resection are often frustrated by the inability to obtain adequate representative tissue for frozen section. Choledochoscopic biopsies and incisional biopsies have given the highest yield of positive diagnoses. In experienced hands, a program of fewer preoperative tests with emphasis on early operation, diagnosis, and definitive treatment may be more cost-effective in the management of patients with common bile duct cancer.
一项对接受胆总管癌治疗患者的回顾性研究表明，诊断能力有所提高，从而能够通过手术治疗更早地进行处理。切除这些肿瘤的能力直接转化为长期生存率的提高。在切除术前努力获取恶性肿瘤证据的做法，常常因无法获得足够的代表性组织进行冰冻切片而受挫。经胆管镜活检和切开活检的阳性诊断率最高。在经验丰富的医生手中，一个减少术前检查、强调早期手术、诊断和确定性治疗的方案，在胆总管癌患者的管理中可能更具成本效益。
