肝内胆管细胞癌的外科治疗进展

Advancement in surgical treatment of intrahepatic cholangiocarcinoma

肝内胆管细胞癌（ICC）具有显著的局部播散和淋巴道转移的特性.治愈ICC的惟一选择是根治性手术,应行规则性肝切除或扩大肝切除 是否常规清扫淋巴结以及淋巴结清扫的范围目前研究较多,结论有待进一步证实.姑息性切除仍然可以改善部分病人的预后.再次手术对于术后＂超过一年＂的部分肝内复发病人也有较好的疗效.肝移植仅适用于高度选择的早期病人或者谨慎的临床试验,并建议联合术后放化疗等以改善预后.

Intrahepatic cholangiocarcinoma （ICC） has the significant characteristics of regional spread and lymphatic metastasis. Radical resection provides the only chance for long-term survival of patients with ICC. Anatomic or extended hepatectomy is the most optimal treatment. The value of hepatic resection with lymph node dissection and the area of lymph node dissection are controversial. Palliative resection improves prognosis of some patients. Secondary hepatectomy also benefits some patients with late （〉1 year） intrahepatic recurrence. Liver transplantation is only performed for highly selected prophase-patients or prudent clinical trials, and a combination with adjuvant treatment such as chemo-radiotherapy after operation is suggested.