外科理论与实践 ›› 2023, Vol. 28 ›› Issue (02): 104-109.doi: 10.16139/j.1007-9610.2023.02.04

• 专家论坛 • 上一篇    下一篇

肝门部胆管癌根治性切除术中的血管重建技术

李相成(), 陈妍安澜, 李长贤   

  1. 南京医科大学第一附属医院肝胆中心,江苏 南京 210029
  • 收稿日期:2023-01-29 出版日期:2023-03-25 发布日期:2023-06-06
  • 通讯作者: 李相成,E-mail:drxcli@njmu.edu.cn

Vascular reconstruction in radical resection for hilar cholangiocarcinoma

LI Xiangcheng(), CHEN Yananlan, LI Changxian   

  1. Hepatobiliary Center, the First Affiliated Hospital with Nanjing Medical University, Jiangsu Nanjing 210029, China
  • Received:2023-01-29 Online:2023-03-25 Published:2023-06-06

摘要:

根治性手术切除是治愈肝门部胆管癌的唯一治疗选择。镜下胆管切缘阴性(R0切除)对病人长期生存至关重要。然而,因肝门部胆管癌常合并门静脉、肝动脉浸润,无法得到阴性切缘。联合血管切除重建为解决这一难题提供了可能。目前,合并门静脉及肝动脉切除重建的临床价值已得到充分的肯定。本文论述肝门部胆管癌根治术中的门静脉、肝动脉重建技术及其临床价值,术前影像学评估和术后并发症。

关键词: 肝门部胆管癌, 血管切除重建, 门静脉, 肝动脉

Abstract:

Radical resection is the only option of curative treatment for hilar cholangiocarcinoma. Microscopically negative resection margin of bile duct (R0 resection) is critical for long-term survival of patients. However, both portal vein and hepatic artery invasions from hilar cholangiocarcinoma were often found, the negative resection margin could not be gotten. Combined vascular resection and reconstruction provide a possible way to solve this problem. At present, the clinical value of resection of portal vein and hepatic artery combining with reconstruction has been fully recognized. The technique of reconstruction for both portal vein and hepatic artery combined with the clinical significance, preoperative evaluation of imaging and postoperative complications for hilar cholangiocarcinoma were included in this article.

Key words: Hilar cholangiocarcinoma, Vascular resection and reconstruction, Portal vein, Hepatic artery

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