Lewis Heather L, Rahnemai-Azar Amir A, Dillhoff Mary, Schmidt Carl R, Pawlik Timothy M
Chirurgia (Bucur). 2017 May-Jun;112(3):193-207. doi: 10.21614/chirurgia.112.3.193.
Perihilar cholangiocarcinoma is the most common type of biliary tract cancer and is associated with a high mortality, usually due to late presentation. High-resolution cross-sectional imaging modalities are necessary for diagnosis and preoperative planning. Although surgical resection with negative margins offers the only hope for cure, only a small subset of patients are amenable for surgery at the time of diagnosis. Portal vein embolization and biliary tract decompression are important in some patients prior to surgical resection. Liver transplantation in combination with neoadjuvant therapy has resulted in excellent 5-year recurrence-free survival rates in highly selected patients with inoperable disease. Gemcitabine plus cisplatin constitute the backbone of chemotherapy in patients with inoperable metastatic perihilar cholangiocarcinoma. Recent advances in understanding the molecular pathogenesis of CCA have created a growing interest in identifying novel therapies targeting key molecular pathways. Herein, we provide an overview of the most current principles of management of patients with perihilar cholangiocarcinoma.
肝门部胆管癌是最常见的胆道癌类型，死亡率很高，通常是由于就诊时已处于疾病晚期。高分辨率横断面成像模式对于诊断和术前规划是必要的。尽管切缘阴性的手术切除是治愈的唯一希望，但只有一小部分患者在诊断时适合手术。门静脉栓塞和胆道减压在某些患者手术切除前很重要。肝移植联合新辅助治疗已使高度选择的无法手术的患者获得了出色的5年无复发生存率。吉西他滨加顺铂是无法手术的转移性肝门部胆管癌患者化疗的主要方案。最近在理解胆管癌分子发病机制方面的进展激发了人们对识别针对关键分子途径的新疗法的兴趣日益浓厚。在此，我们概述了肝门部胆管癌患者当前最新的治疗原则。
