外科理论与实践 ›› 2023, Vol. 28 ›› Issue (02): 100-103.doi: 10.16139/j.1007-9610.2023.02.03

• 专家论坛 • 上一篇    下一篇

腹腔镜肝门部胆管癌根治术的现状与思考

朱斯维, 尹新民()   

  1. 湖南省人民医院肝胆微创外科,湖南 长沙 410005
  • 收稿日期:2023-03-14 出版日期:2023-03-25 发布日期:2023-06-06
  • 通讯作者: 尹新民, E-mail:13319587618@163.com
  • 基金资助:
    湖南省科学技术厅项目(2017SK2144)

Laparoscopic radical resection of hilar cholangiocarcinoma: current status and considerations

ZHU Siwei, YIN Xinmin()   

  1. Department of Hepatobiliary Minimally Invasive Surgery,the People's Hospital of Hunan Provincial,Hunan Changsha 410005, China
  • Received:2023-03-14 Online:2023-03-25 Published:2023-06-06

摘要:

腹腔镜肝门部胆管癌根治手术因其紧邻第一肝门而复杂。近年,其在大型医疗中心广泛开展,安全性有了明显提高。本文讨论手术实施的现状,包括手术禁忌证,术前准备的精准评估和胆道引流减黄,团队配合和经验。关键技术涉及血管解剖和淋巴结清扫,包括尾叶的联合肝叶肝段切除以及重建消化道。最后思考与展望腹腔镜肝门部胆管癌根治术。

关键词: 腹腔镜, 肝门部胆管癌, 根治术

Abstract:

Laparoscopic radical resection of hilar cholangiocarcinoma was complex because of the tumor near to hepatic hilum. The resection of hilar cholangiocarcinoma increased in recent years in large medical centers with safety of surgery improved. The current status of laparoscopic radical resection of hilar cholangiocarcinoma was discussed in this article including contraindication of surgery, precision evaluation and obstructive jaundice treated with preoperative biliary duct drainage, coordination among operative team and their experience. The key technology involved both blood vessels and lymphatic nodes dissected and separated which included resection of caudal lobe combined with hepatic lobes and hepatic segments, and then reconstruction of digestive tract. Lastly, there is consideration and prospect of laparoscopic radical resection of hilar cholagiocarcinoma.

Key words: Laparoscopy, Hilar cholangiocarcinoma, Radical resection

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