Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-0856, Japan.
J Hepatobiliary Pancreat Sci. 2010 Jul;17(4):470-5. doi: 10.1007/s00534-009-0207-2. Epub 2009 Nov 21.
Many authors at high-volume centers all over the world have reported improved outcomes of hilar cholangiocarcinoma by several aggressive surgical approaches such as extended hepatic resection, combined vascular resection, and hepatopancreaticoduodenectomy in recent years. There has been great progress in the surgical treatment of hilar cholangiocarcinoma with these previous efforts by aggressive hepatobiliary surgeons. In particular, surgical techniques, diagnostic modalities, and perioperative management have been remarkably improved as compared with before. Herein we report the surgical outcome for both hilar cholangiocarcinoma of Bismuth types II, III, and IV and intrahepatic cholangiocarcinoma involving the hepatic duct confluence during the recent 8-year period between 2001 and 2008 at our institution, the Department of General Surgery at Chiba University. From our recent experienced results, it can be concluded that the surgical strategy for hilar cholangiocarcinoma has been improved remarkably, and major surgical hepatectomy can be done with relative safety, and these aggressive surgical approaches, including combined vascular resection, may be warranted for the surgical treatment of hilar cholangiocarcinoma. However, the adoption of new innovative therapeutic approaches might be required for further improvement of surgical outcome of hilar cholangiocarcinoma.
近年来，许多高容量中心的作者报告了通过几种积极的手术方法，如扩大肝切除术、联合血管切除术和胰十二指肠切除术，改善了肝门部胆管癌的预后。在这些积极的肝胆外科医生的努力下，肝门部胆管癌的手术治疗取得了很大进展。特别是与以前相比，手术技术、诊断方式和围手术期管理都有了显著提高。在此，我们报告了 2001 年至 2008 年 8 年间我院普通外科（千叶大学）治疗的胆道癌Ⅱ、Ⅲ、Ⅳ型和肝内胆管癌累及肝总管汇合部的手术结果。从我们最近的经验结果来看，可以得出结论，肝门部胆管癌的手术策略已经显著改善，主要的肝切除术可以相对安全地进行，包括联合血管切除术在内的这些积极的手术方法可能是治疗肝门部胆管癌的必要手段。然而，可能需要采用新的创新治疗方法来进一步提高肝门部胆管癌的手术效果。
