Miyazaki Masaru, Shimizu Hiroaki, Yoshitomi Hideyuki, Kato Atsushi, Furukawa Katsunori, Takayashiki Tsukasa, Kuboki Satoshi, Takano Shigetsugu, Ohtsuka Masayuki
Department of General Surgery Chiba University Chiba Japan.
Department of Gastroenterological Surgery Mita Hospital International University of Health & Welfare Tokyo Japan.
Ann Gastroenterol Surg. 2017 Sep 14;1(3):164-170. doi: 10.1002/ags3.12036. eCollection 2017 Sep.
Although recent advances in imaging diagnosis, surgical techniques, and perioperative management can result in increased resectability and improved surgical outcomes, most resected patients still develop cancer recurrence. If patients develop cancer recurrence, their prognosis is very ominous. However, there have been some recent reports to show promising outcomes by aggressive surgical strategy in selected patients who developed cancer recurrence. Because there are various surgical procedures being selected at initial surgery in patients with biliary tract cancers, recurrent patterns after resection are very variable in each patient. However, surgical procedures might usually be very complicated and difficult if re-surgical resection is considered in patients with recurrent biliary tract cancer, Therefore, surgical re-resection could bring about high surgical morbidity and mortality rates in most previously reported series. Although re-surgical resection might offer a chance of favorable outcome in selected patients with biliary tract cancers, these aggressive surgical approaches should be carried out in strictly selected patients by expert surgeons at high-volume centers.
尽管近期在影像诊断、手术技术和围手术期管理方面取得了进展，可提高肿瘤切除率并改善手术效果，但大多数接受手术切除的患者仍会出现癌症复发。如果患者出现癌症复发，其预后非常凶险。然而，最近有一些报告显示，对于某些出现癌症复发的特定患者，积极的手术策略能带来良好的治疗效果。由于胆管癌患者在初次手术时会选择多种手术方式，切除术后的复发模式在每个患者中差异很大。然而，如果考虑对复发性胆管癌患者进行再次手术切除，手术过程通常会非常复杂且困难。因此，在大多数先前报道的系列研究中，再次手术切除可能导致较高的手术并发症发生率和死亡率。尽管再次手术切除可能为某些胆管癌患者带来良好预后的机会，但这些积极的手术方法应由高容量中心的专家外科医生在严格筛选的患者中进行。
