肝内胆管细胞癌的外科治疗策略

Strategy for surgical treatment of intrahepatic cholangiocarcinoma

肝内胆管细胞癌(ICC)恶性程度高,侵袭性极强,术后复发率和转移率高,远期生存极差。根治性切除术是ICC患者可以获得痊愈的唯一治疗手段。ICC的治疗应采用积极手术为主的多学科治疗模式,根治性切除和术中常规区域淋巴结清扫可延长患者生存期,术后辅以有效的辅助治疗,可以改善ICC患者的预后。对于无法一期切除的ICC患者,行新辅助治疗,部分患者可以达到降期目的,并获得根治性切除的机会。对复发性ICC应采用多学科治疗。

Intrahepatic cholangiocarcinoma(ICC)is a high malignant tumor,which has strong invasive,high postoperative recurrent and metastatic,and poor prognosis.Surgical resection is still the most preferred treatment for patients with ICC.The multi-disciplinary team strategy should be adopted in the treatment of ICC,which active surgery is the first choice.Radical resection and routine regional lymph node dissection with effective postoperative adjuvant therapy can improve the patient′s survival and prognosis.Neoadjuvant chemotherapy is recommended as a downstaging option for initially unresectable patients with ICC so that part of patients can obtain the opportunity of R0 resection.The recurrent ICC patients should be treated in a multidisciplinary mode.