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联合血管切除重建在肝门部胆管癌根治术中的应用进展

Application progress of combined vascular resection and reconstruction in radical resection of hilar cholangiocarcinoma

  • 摘要: 外科根治性切除目前仍然是肝门部胆管癌最为有效且唯一有可能达到根治目的的治疗策略。既往认为肿瘤浸润门静脉或肝动脉被认为是手术禁忌证,是阻碍手术达到肿瘤阴性切缘(R0切除)关键因素。但随着血管外科技术的发展和提高,这些禁忌已经部分被突破。目前合并门静脉切除重建的肝门部胆管癌根治术的安全性和效果已得到充分肯定,有利于患者的预后且不显著增加围术期风险,但是否合并肝动脉切除重建仍有分歧。本文旨就肝门部胆管癌根治术合并血管切除重建的研究进展作综述。

     

    Abstract: At present, surgical radical resection is still the most effective treatment for hilar cholangiocarcinoma, and the only treatment strategy that is likely to achieve radical cure. Previously, the invasion of the portal vein or hepatic artery by tumors is considered to be a contraindication to surgery, and is a key factor that prevents surgery from reaching the tumor-negative margin (R0 resection). With the development and improvement of vascular surgery technology, these taboos have been partially broken. Until now, the safety and effect of radical resection of hilar cholangiocarcinoma resection combined with portal vein resection have been fully affirmed, which is beneficial to the prognosis of patients and does not significantly increase the perioperative risk. However, there is still disagreement on whether to recombine hepatic artery resection and reconstruction. The purpose of this study is to evaluate the feasibility and safety of radical resection of hilar cholangiocarcinoma with vascular resection and reconstruction.

     

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