肝门胆管癌的治疗进展

Current management of hilar cholangiocarcinoma

肝门部胆管癌因其发生部位特殊、呈浸润性生长及与肝门部血管关系密切等特点给手术切除造成极大的困难.长期以来,肝门部胆管癌被认为是无法手术根治性切除的癌肿.近20年来,随着影像学和手术技术的进步,使肝门部胆管癌的诊断和治疗取得重大进步,手术切除率逐步提高,生存率得到明显改善.但是对于是否应行扩大根治术、血管切除重建,以及放化疗等的疗效问题,依然是肝胆外科及肿瘤科医生所面临的严峻挑战.本文就肝门部胆管癌的治疗进展作一综述.

Hilar cholangiocarcinoma is a rare tumor with poor prognosis. Surgical resection provides the only possibility for cure. Due to the central anatomic localization within the liver hilum, established guidelines of oncologic surgery are difficult to apply. Advances in hepatobiliary imaging and surgical strategies to treat this disease have resulted in improved postoperative outcomes. However, selection of extended hepatectomy or vascular resection or not as well as the efficacy of chemiotherapy remain great challenges to hepatobiliary surgeons. Here, we will review the recent advances in the management of hilar cholangiocarcinoma.