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腹腔镜左半肝切除术治疗肝内胆管细胞癌。

Laparoscopic Left Hepatectomy for Intrahepatic Cholangiocarcinoma.

机构信息

Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.

Management Center, General Practice Center, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Ann Surg Oncol. 2024 May;31(5):3059-3061. doi: 10.1245/s10434-024-14905-w. Epub 2024 Jan 27.

DOI:10.1245/s10434-024-14905-w
PMID:38280962
Abstract

BACKGROUND

Minimally invasive surgery for intrahepatic cholangiocarcinoma (ICC) remains challenging, especially in advanced patients.

PATIENT AND METHOD

A 66-year-old male was diagnosed with stage II ICC after a comprehensive evaluation and was scheduled for laparoscopic exploration and left hepatectomy.

RESULTS

The pure laparoscopic left hepatectomy was completed in 240 min, employing a no-touch en bloc technique and lymphadenectomy skeletonization. The patient was discharged 6 days after the operation without any complications and received gemcitabine and cisplatin treatment postoperatively. There was no recurrence during 14 months of follow-up.

CONCLUSIONS

Our experience demonstrates that when utilizing the no-touch en bloc technique, standardized lymphadenectomy through skeletonization, and effective control of bleeding, surgeons with extensive expertise in laparoscopic hepatectomy can achieve results comparable to open surgery.

摘要

背景

肝内胆管癌(ICC)的微创手术仍然具有挑战性,尤其是对于晚期患者。

患者与方法

一名 66 岁男性经过全面评估后被诊断为 II 期 ICC,并计划进行腹腔镜探查和左半肝切除术。

结果

采用无接触整块技术和淋巴结清扫骨架化,纯腹腔镜左半肝切除术在 240 分钟内完成。患者术后 6 天出院,无任何并发症,并接受了吉西他滨和顺铂治疗。在 14 个月的随访期间无复发。

结论

我们的经验表明,当利用无接触整块技术、通过骨架化进行标准化淋巴结清扫,并有效控制出血时,具有丰富腹腔镜肝切除术专业知识的外科医生可以取得与开放手术相当的结果。

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本文引用的文献

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Death-associated protein 3 in cancer-discrepant roles of DAP3 in tumours and molecular mechanisms.癌症中的死亡相关蛋白3——DAP3在肿瘤中的不同作用及分子机制
Front Oncol. 2024 Jan 30;13:1323751. doi: 10.3389/fonc.2023.1323751. eCollection 2023.
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Laparoscopic versus open hepatectomy for intrahepatic cholangiocarcinoma: Systematic review and meta-analysis of propensity score-matched studies.腹腔镜与开腹肝切除术治疗肝内胆管癌:倾向评分匹配研究的系统评价与荟萃分析
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Advances in the treatment of intrahepatic cholangiocarcinoma: An overview of the current and future therapeutic landscape for clinicians.
肝内胆管癌治疗进展:临床医生当前及未来治疗前景概述
CA Cancer J Clin. 2023 Mar;73(2):198-222. doi: 10.3322/caac.21759. Epub 2022 Oct 19.
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Systemic therapies for intrahepatic cholangiocarcinoma.肝内胆管细胞癌的系统治疗。
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Lateral thermal damage of mesoappendix and appendiceal base during laparoscopic appendectomy in children: comparison of the harmonic scalpel (Ultracision), bipolar coagulation (LigaSure), and thermal fusion technology (MiSeal).小儿腹腔镜阑尾切除术中阑尾系膜及阑尾根部的侧向热损伤:超声刀(Ultracision)、双极电凝(LigaSure)和热融合技术(MiSeal)的比较
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Impact of low-thermal-injury devices on margin status in laryngeal cancer. An experimental ex vivo study.低热量损伤设备对喉癌切缘状态的影响。一项离体实验研究。
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Surg Oncol Clin N Am. 2009 Apr;18(2):xv-xvi. doi: 10.1016/j.soc.2009.02.001.