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肝门部胆管癌腹腔镜根治性切除术操作规范专家推荐共识会议

A Consensus Meeting on Expert Recommendations on Operating Specifications for Laparoscopic Radical Resection of Hilar Cholangiocarcinoma.

作者信息

Xiong Yongfu, Jingdong Li, Zhaohui Tang, Lau Joseph

机构信息

Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

Institute of Hepato-Biliary-Pancreatic-Intestinal Disease, North Sichuan Medical College, Nanchong, China.

出版信息

Front Surg. 2021 Nov 23;8:731448. doi: 10.3389/fsurg.2021.731448. eCollection 2021.

Abstract

With advances in techniques and technologies, laparoscopic radical resection of hilar cholangiocarcinoma (HCCA) has gradually been carried out in major medical centers in China. Its feasibility and safety have been accepted by a group of Chinese surgical experts. To standardize perioperative management of HCCA by using laparoscopic resectional approach, to ensure safety of the patient with standardized management, improve prognosis of the patient, and enable proper application and refinement of this surgical approach, the expert group on specifications for laparoscopic radical resection of HCCA in China organized a consensus meeting. Laparoscopic radical resection of HCCA is difficult and associated with high risks. Appropriate patients should be carefully selected and this surgical approach should be promoted gradually. The experts met and arrived at 16 recommendations on perioperative management of HCCA by using laparoscopic surgery. There were three recommendations on preoperative diagnosis and evaluation; one recommendation on surgical principles of treatment; one recommendation on indications and contraindications; one recommendation on credentialing, staffing, and equipment; nine recommendations on laparoscopic techniques in different stages of operation; and one recommendation on indications for conversion to open surgery. Laparoscopic surgery for HCCA is still in the early phase of development. This consensus provides a clinical reference with the aim to promote and to facilitate its further development.

摘要

随着技术的进步,腹腔镜下肝门部胆管癌根治性切除术(HCCA)已逐渐在中国各大医疗中心开展。其可行性和安全性已被一批中国外科专家所认可。为规范采用腹腔镜切除方法的HCCA围手术期管理,确保患者安全,通过规范管理改善患者预后,并使该手术方法得到恰当应用和完善,中国腹腔镜下肝门部胆管癌根治性切除术规范专家组组织了一次共识会议。腹腔镜下HCCA根治性切除术难度大且风险高。应谨慎选择合适的患者,并逐步推广这种手术方法。专家们齐聚并就采用腹腔镜手术的HCCA围手术期管理达成了16项建议。其中包括关于术前诊断与评估的3项建议;关于手术治疗原则的1项建议;关于适应证与禁忌证的1项建议;关于资质、人员配备和设备的1项建议;关于手术不同阶段腹腔镜技术的9项建议;以及关于中转开腹手术适应证的1项建议。腹腔镜下HCCA手术仍处于发展初期。本共识提供了临床参考,旨在促进并推动其进一步发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd70/8651246/456c65077103/fsurg-08-731448-g0001.jpg

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