肝外胆管切除在胆囊癌根治性切除术中的应用与价值

Applications and values of combined excision of extrahepatic bile duct in curative resection of gallbladder carcinoma

根治性切除术是胆囊癌惟一有希望获得治愈的手段。对于肿瘤已侵犯肝外胆管者,为了获得根治性切除必须联合肝外胆管切除。但是,对于肝外胆管未受肿瘤侵犯者,是否需要常规联合肝外胆管切除目前尚存在争议。虽然联合肝外胆管切除有助于区域淋巴结清扫及清除一些潜在的隐匿肿瘤细胞,但其一方面会增加手术风险及术后并发症发生率,另一方面对病人远期生存获益尚未确定。

Curative resection remains as the only hope of cure for gallbladder carcinoma. For gallbladder carcinoma invading the extra-hepatic bile duct, combined excision of extra-hepatic bile duct should be undertaken for achievement of curative resection of tumor. However, for gallbladder carcinoma without invasion of extra-hepatic bile duct, there exist controversies about applications and values of combined excision of extra-hepatic bile duct. Combined excision of extra-hepatic bile duct is helpful in clearance of regional lymph nodes, and clearance of some potentially hidden cancer ceils： However, it increases the operative risk and postoperative complication incidence. Furthermore, its survival benefits have not been well-documented.