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Perihilar cholangiocarcinoma:a surgeon's perspective

iLIVER 2022年第1期1卷 12-24页

作者： Masato Nagino Department of Gastroenterological surgery Aichi Cancer Center1-1 KanokodenChikusa-kuNagoya464-8681Japan

Perihilar cholangiocarcinoma(PHC)is defined anatomically as tumors located in the extrahepatic biliary tree proximal to the origin of the cystic ***,as the boundary between the extrahepatic and intrahepatic bile ducts is not well defined,PHC potentially includes two types of tumors:one is the extrahepatic type,which arises from the large hilar bile duct,and the other is the intrahepatic type,which has an intrahepatic component with invasion of the hepatic *** new American Joint Commission on Cancer tumor-node-metastasis staging system for PHC was well revised;an important revision is that the Bismuth type IV was removed from T4 stage *** patients with PHC present with obstructive jaundice,and preoperative biliary drainage is ***,percutaneous transhepatic biliary drainage was used in many centers;however,it has been accepted that endoscopic nasobiliary drainage is the most suitable method for ***,inside-stents have also been adopted for biliary drainage,with favorable *** vein embolization is widely performed as presurgical treatment for patients undergoing extended hepatectomy to minimize postoperative liver *** resection of PHC is technically demanding and continues to be the most difficult challenge for hepatobiliary *** of advances in diagnostic and surgical techniques,surgical outcomes and survival rates after resection have steadily ***,survival rates,especially for patients with lymph node metastasis,are unsatisfactory,and establishing a protocol for effective adjuvant chemotherapy is an urgent *** synergy of endoscopists,radiologists,oncologists,and surgeons is required to conquer this intractable disease.

关键词： Perihilar cholangiocarcinoma Biliary drainage Portal vein embolization extended surgery

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