Bork U, Koch M, Büchler M W, Weitz J
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Chirurgische Klinik, Universitätsklinikum Heidelberg.
Chirurg. 2010 Feb;81(2):111-16. doi: 10.1007/s00104-009-1812-y.
Surgical R0 resection of primary and secondary hepatobiliary tumors, such as colorectal liver metastases, hepatocellular carcinoma, cholangiocellular carcinoma and gall bladder carcinoma, remains the only potentially curative treatment option. The extent of involvement of lymph node metastases seems to be an independent prognostic factor in these tumors. The prognostic value of a systematic lymph node dissection in hepatobiliary tumors still remains unclear as there is a lack of prospective randomized trials. However, local lymphadenectomy (hepatoduodenal ligament and retropancreaticoduodenal lymph nodes) can be easily performed with low mortality and morbidity rates and may be helpful in better staging of the patients. Further randomized trials are necessary in order to define the relevance of lymph node dissection in hepatobiliary surgery.
对原发性和继发性肝胆肿瘤（如结直肠癌肝转移、肝细胞癌、胆管细胞癌和胆囊癌）进行手术R0切除，仍然是唯一可能治愈的治疗选择。淋巴结转移的累及范围似乎是这些肿瘤的一个独立预后因素。由于缺乏前瞻性随机试验，系统性淋巴结清扫在肝胆肿瘤中的预后价值仍不明确。然而，局部淋巴结切除术（肝十二指肠韧带和胰十二指肠后淋巴结）操作简便，死亡率和发病率低，可能有助于更好地对患者进行分期。为了明确淋巴结清扫在肝胆外科手术中的相关性，有必要进行进一步的随机试验。
