肝门部胆管癌淋巴结清扫的研究进展

Research progress of lymph node dissection in hilar cholangiocarcinoma

肝门部胆管癌发病率低,外科切除仍然是可能治愈的唯一手段,但是根治性切除率低,预后极差。淋巴结转移是影响肝门部胆管癌患者生存的最重要因素之一,伴有淋巴结转移的患者长期生存率明显差于淋巴结未转移患者。近年来,肝门部胆管癌根治性切除联合淋巴结清扫的观点已达成共识,淋巴结清扫已是肝门部胆管癌外科治疗中的重要环节。除了少数早期肝门部胆管癌患者无需淋巴结清扫,大多数需联合施行区域淋巴结清扫,但是对于是否必要扩大淋巴结清扫及扩大淋巴清扫能否获得生存益处仍存在颇多争论。本文将从肝门部胆管癌淋巴结清扫共识及扩大淋巴清扫之争议两个方面对肝门部胆管癌淋巴结清扫做一综述。

The incidence of hilar cholangiocarcinoma is relatively low,and surgical resection remains the only curative treatment option.However,the probability of radical curative resection is low,and the prognosis is very poor.Lymph node metastasis is one of the most important factors related to survival in patients with perihilar cholangiocarcinoma,the long-term survival rate of patients with lymph node metastasis is significantly worse than that of patients without lymph node metastasis.In recent years,radical resection of hilar cholangiocarcinoma combined with lymph node dissection has been applied for the treatment.Lymph node dissection has become a critical part in the surgical treatment of hilar cholangiocarcinoma,except for a few patients with early hilar cholangiocarcinoma,most of the patients need the regional lymph node dissection,but there is still a lot of controversies on whether it is necessary to expand the lymph node dissection region and whether the patients will benefit from the treatment.This article will discuss the lymph node dissection of hilar cholangiocarcinoma on two parts:the consensus of lymph node dissection and the controversy of expanded lymph node dissection.