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肝门部胆管癌肝移植术的方案。

PROTOCOL FOR LIVER TRANSPLANTATION IN HILAR CHOLANGIOCARCINOMA.

机构信息

Department of Gastroenterology, Hospital de Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.

Department of General Surgery and Transplantation, Hospital Adventista Silvestre, Rio de Janeiro, RJ, Brazil.

出版信息

Arq Bras Cir Dig. 2022 Jan 5;34(3):e1618. doi: 10.1590/0102-672020210002e1618. eCollection 2022.

Abstract

BACKGROUND

Hilar cholangiocarcinoma represents more than half of all cholangiocarcinoma cases, having poor prognosis and presenting a median overall survival after diagnosis of 12-24 months. In patients who have unresectable tumors with a better prognosis, the proposal to perform liver transplantation emerged for expanding the possibility of free margins by performing total hepatectomy.

AIM

To provide a Brazilian protocol for liver transplantation in patients with hilar cholangiocarcinoma.

METHOD

The protocol was carried out by two Brazilian institutions which perform a large volume of resections and liver transplantations, based on the study carried out at the Mayo Clinic. The elaboration of the protocol was conducted in four stages.

RESULT

A protocol proposal for this disease is presented, which needs to be validated for clinical use.

CONCLUSION

The development of a liver transplantation protocol for cholangiocarcinoma aims not only to standardize the treatment, but also enable a better assessment of the surgical results in the future.

摘要

背景

肝门部胆管癌占胆管癌病例的一半以上,预后较差,诊断后中位总生存期为 12-24 个月。对于有不可切除肿瘤且预后较好的患者,提出行肝移植的建议,以通过行全肝切除术扩大无肿瘤切缘的可能性。

目的

提供巴西肝门部胆管癌患者肝移植的方案。

方法

该方案由两家巴西机构制定,这两家机构进行了大量的切除术和肝移植,该方案基于梅奥诊所的研究。方案的制定分四个阶段进行。

结果

提出了一种针对这种疾病的方案建议,该方案需要经过验证才能用于临床。

结论

制定胆管癌肝移植方案不仅旨在规范治疗,而且还能为未来更好地评估手术结果提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0285/8735267/22f09c1edccd/0102-6720-abcd-34-03-e1618-gf1.jpg

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