晚期Ⅲ型和Ⅳ型肝门部胆管癌减黄引流术的选择

Selection of draining and reducing jaundice for hilar cholangiocarcinoma with advanced type Ⅲ and Ⅳ

肝门部胆管癌是一种来源于左右肝管、肝总管及其汇合部位的恶性肿瘤。Ⅲ型和Ⅳ型肝门部胆管癌是按Bismuth-Corlette分型中发生在胆囊管开口以上且向肝内侵犯至左右一级或二级胆管分支的胆管癌。其早期临床症状不明显,多数患者在就诊时已处晚期,同时解剖位置特殊,手术难度大,R0切除率低。因此,大部分患者只能行姑息性减黄引流治疗,为进一步加深对Ⅲ型和Ⅳ型肝门部胆管癌姑息性减黄引流治疗的了解,本文就近年来相关的研究进展做一综述。

Hilar cholangiocarcinoma is a malignant disease which initiated in the main left or right hepatic ducts, ductus hepaticus communis or their confluence. Type Ⅲand Ⅳhilar cholangiocarcinoma according to Bismuth-Corlette classification originate from the superior region of the junction of ductus cysticus and common bile duct, with left/right primary branch invasion or secondary branch invasion, respectively. For lack of tipical symptoms,most patients are diagnosed at advanced stage. Meanwhile,because of special anatomical structures, difficulty in operation and low rate for RO resection, most patients can only undergo palliative treatment of draining and reducing jaundice.In order to deepen the understanding of the palliative treatment of draining and reducing jaundice for Type Ⅲand Ⅳhilar cholangiocarcinoma,this review summarized the related research progress.