Petrowsky H, Hong J C
Pfleger Liver Institute, Dumont-UCLA Liver Cancer and Transplant Centers, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, California 90095-7054, USA.
Transplant Proc. 2009 Dec;41(10):4023-35. doi: 10.1016/j.transproceed.2009.11.001.
Cholangiocarcinoma (CCA) is a rare but devastating malignancy that presents late, is notoriously difficult to diagnose, and is associated with a high mortality. Surgical resection is the only chance for cure or long-term survival. The treatment of CCA has remained challenging because of the lack of effective adjuvant therapy, aggressive nature of the disease, and critical location of the tumor in close proximity to vital structures such as the hepatic artery and the portal vein. Moreover, the operative approach is dictated by the location of the tumor and the presence of underlying liver disease. During the past 4 decades, the operative management of CCA has evolved from a treatment modality that primarily aimed at palliation to curative intent with an aggressive surgical approach to R0 resection and total hepatectomy followed by orthotopic liver transplantation.
胆管癌（CCA）是一种罕见但极具破坏性的恶性肿瘤，其发病较晚，诊断 notoriously 困难，且死亡率高。手术切除是治愈或长期生存的唯一机会。由于缺乏有效的辅助治疗、疾病的侵袭性以及肿瘤紧邻肝动脉和门静脉等重要结构的关键位置，CCA 的治疗一直具有挑战性。此外，手术方式取决于肿瘤的位置和潜在肝脏疾病的存在。在过去的 40 年里，CCA 的手术管理已从主要旨在缓解症状的治疗方式演变为具有根治意图的积极手术方法，即进行 R0 切除和全肝切除，随后进行原位肝移植。
