肝外胆道肿瘤治疗的新进展

Progress in the Treatment of Extrahepatic Bile Duct Carcinoma

肝外胆道肿瘤是一种恶性程度较高、预后较差的肿瘤,手术治疗是其唯一有治愈可能的治疗方法。根治性手术切除时常需联合血管或肝尾状叶切除及行区域淋巴结清扫,姑息切除加术后辅助治疗也可延长患者的生存时间并提高生活质量。对重度黄疸或预计术后肝残余量不足患者,术前行健侧胆道引流或病肝侧门静脉栓塞术,可减少术后并发症。对不能手术切除或伴有转移的进展期胆管癌,化疗、放疗、分子靶向药物、介入等治疗具有一定改善整体生存和生活质量的作用,并可能获得二次手术机会。

Extrahepatic biliary carcinoma is a highly malignant tumor with poor prognosis. Surgical treatment is the only potentially curative treatment. Radical resection often need to combine with vascular or caudate lobe of liver resection and regional lymph node dissection. Palliative resection and postoperative adjuvant therapy may prolong the survival time of patients and improve the quality of life. For the patients with severe jaundice or expected postoperative insufficient residual liver,preoperative contralateral biliary drainage or hepatic portal embolization may reduce postoperative complications. For patients with unresectable advanced bile duct can- cer or compliated with metastasis,radiotherapy, chemotherapy, molecular targeted agents and interventional therapy may partly improve overall survival and quality of life,and might achieve opportunity for operation.