Chirurgia (Bucur). 2023 Dec;118(6):553-567. doi: 10.21614/chirurgia.2023.v.118.i.6.p.553.
Intrahepatic cholangiocarcinomas represent rare and aggressive malignancies developing from the second order bile ducts to the smaller biliary branches. The aim of this narrative review is to discuss about the main diagnostic and therapeutic challenges in order to help medical and surgical oncologists to gain familiarity in regard to this subject. Articles discussing about epidemiology, histology, diagnostic, perioperative management and surgery which were published from January 2000 to September 2023 included in Cochrane Library, PubMed, Embase, MedLine, Web of Science, Elsevier, Google Scholar databases were reviewed. Articles reviewed in the current paper came to demonstrate that the main problem in such cases is related to the fact that most cases remain asymptomatic for a long period of time and therefore are diagnosed in advanced stages of the disease when curative procedures are feasible after performing extended visceral sacrifice or even worse, are no longer possible; however, the most efficient therapeutic strategy in order to improve the long term outcomes remains radical surgery. In this respect, attention was focused on improving the accuracy of the diagnostic tools and on identifying non-surgical therapeutic options which might increase the chances of achieving complete resection. Intrahepatic cholangiocarcinoma represent rare aggressive tumors with poor outcomes especially if radical surgery is not feasible.
肝内胆管细胞癌是一种罕见且侵袭性的恶性肿瘤,起源于二级胆管至较小的胆管分支。本综述旨在讨论主要的诊断和治疗挑战,以帮助内科和外科肿瘤医生熟悉这一领域。本文纳入了 2000 年 1 月至 2023 年 9 月期间在 Cochrane Library、PubMed、Embase、MedLine、Web of Science、Elsevier、Google Scholar 数据库中发表的关于肝内胆管细胞癌的流行病学、组织学、诊断、围手术期管理和手术的文章。本文回顾的研究表明,此类患者的主要问题在于大多数患者在很长一段时间内无症状,因此在疾病的晚期才被诊断出来,此时可行根治性手术切除,但需要进行广泛的内脏切除,甚至更糟的是,在无法进行根治性手术的情况下,仍然没有有效的治疗方法;然而,为了提高长期预后,最有效的治疗策略仍然是根治性手术。在这方面,人们的注意力集中在提高诊断工具的准确性和识别非手术治疗方法上,这些方法可能会增加实现完全切除的机会。肝内胆管细胞癌是一种罕见的侵袭性肿瘤,预后较差,特别是在无法进行根治性手术的情况下。