Giordano G, Mustacchio N, Carrassa G, D'Abbicco D, Tumolo R, Santarcangelo G, Ialongo P, Ventolone R
Cattedra di Chirurgia Generale, Università degli Studi di Bari.
G Chir. 1995 Jun-Jul;16(6-7):315-9.
The authors report their experience in 19 cases of primitive or secondary tumor of the hilus of the liver which couldn't benefit from radical operation. Palliative treatments--to resolve the jaundice (which is often the only responsible for a short-term exitus)--include surgical (intrahepatic bilio-digestive derivations) and non surgical procedures (PTDB, percutaneous transtumoral intubation). Considering the ephemeral results of the latter, the Authors take peripheral derivative operations into account and particularly the Soupault and Couinaud technique (intrahepatic colangiojejunostomy) performed in 7 patients with satisfying results. It is an easy and quick technique--because of constant anatomical situation of the left intrahepatic biliary distribution and of the superficial location of the duct of the III segment--which allows a lasting biliary decompression with a good residual life.
作者报告了他们对19例无法从根治性手术中获益的原发性或继发性肝门部肿瘤的治疗经验。姑息性治疗——旨在解决黄疸问题（黄疸往往是导致短期死亡的唯一原因）——包括手术治疗（肝内胆管-消化道转流术）和非手术治疗（经皮经肝胆道引流术、经皮肿瘤内插管术）。考虑到后者效果短暂，作者考虑了外周转流手术，尤其是对7例患者实施的苏帕尔和库尼亚德技术（肝内胆管空肠吻合术），效果令人满意。这是一种简单快捷的技术——由于左肝内胆管分布的解剖位置恒定以及第三肝段胆管位置表浅——能够实现持久的胆道减压并延长生存期。
