肝门部胆管癌手术切除范围的争议及诊疗进展

Controversies over the extent of surgical resection for hilar cholangiocarcinoma and research advances in diagnosis and treatment

肝门部胆管癌(HCCA)是肝外胆管常见的恶性肿瘤,具有解剖位置特殊、肿瘤沿胆管生长、肿瘤恶性程度高、易侵犯肝实质等特点。目前HCCA主要的治疗方式包括手术切除、非手术胆道引流、新辅助放化疗、光动力学疗法等,但手术切除仍是其首选方法。关于HCCA术前是否需要减黄和门静脉栓塞及手术切除范围一直存在争议。对HCCA的临床分型、术前检查及诊断、治疗方法的进展进行阐述。

Hilar cholangiocarcinoma(HCCA)is a common malignant tumor of the extrahepatic bile duct and has the features of special anatomical location,tumor growth along the bile duct,high degree of malignancy,and easy involvement of liver parenchyma.At present,the treatment methods for HCCA include surgical resection,non-surgical biliary drainage,neoadjuvant chemoradiotherapy,and photodynamic therapy,but surgical resection is still the preferred method.There are still controversies over the need for preoperative biliary drainage,portal vein thrombosis,and extent of surgical resection.This article elaborates on the research advances in the clinical typing of HCCA,preoperative examination and diagnosis,and treatment methods.