检索结果-南通市图书馆

hilar cholangiocarcinoma:preoperative evaluation with a three dimensional volumetric interpolated breath-hold examination magnetic resonance imaging sequence

引用

Chinese Medical Journal 2007年第8期120卷 636-642页

作者： YIN Long-lin SONG Bin XU Juan LI Ying-chun Department of Radiology West China Hospital Sichuan University Chengdu 610041 China

Background Early detection and accurate staging are crucial for planning treatment and improving survival rate of hilar cholangiocarcinomas. This study investigated the diagnostic value of a three dimensional, spoiled gradient echo, Tl-weighted magnetic resonance （MR） imaging sequence （3D volumetric interpolated breath-hold examination, 3D-VIBE） in the preoperative evaluation of hilar cholangiocarcinoma. Methods Thirty-one patients with surgically and histologically confirmed hilar cholangiocarcinomas underwent preoperative MR imaging examination. Unenhanced two-dimensional T1- and T2-weighted images, 2D MR cholangiopancreatographs （MRCP）, gadolinium enhanced 3D-VIBE images in the early arterial, late arterial and portal venous phases followed by 2D Tl-weighted images in the equilibrium phase were acquired. Images from 3D-VIBE, 2D T1-weighted enhanced sequences and 2D MRCP were interpreted by two abdominal radiologists through consensus reading in blind manner, focussing on the assessment of the morphological type, the longitudinal extent of tumor infiltration in the bile ducts and the involvement of neighbouring blood vessels. The accuracy of 3D-VIBE and 2D T1-weighted enhanced sequences in assessing the tumor resectability was compared. Results All the 31 tumors were directly displayed and accurately classified on 3D-VIBE images whereas 8 periductal infiltrating tumors （8/31, 25.8%） were not depicted on 2D T1-weighted enhanced images. Using the Bismuth Corlette classification, 3D-VIBE was closer to MRCP in delineating the intraductal extent of tumor infiltration than 2D T1-weighted enhanced （28/31, 90.3%; 10/31, 32.3%; x^2=22.0, P〈0.05）. Involvement of the hepatic artery, the portal venous trunk and their branches was shown more frequently on 3D VIBE than 2D T1-weighted enhanced images. The positive predictive value and accuracy of 3D-VIBE （84.2%; 90.3%） for assessing tumor resectability were higher than those of 2D T1-weighted enhanced images （64.0%; 71.0%, all P〈0.05）. Conclusion Gadolinium enhanced 3D-

关键词： cholangiocarcinoma hilar dynamic imaging magnetic resonance imaging

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Prognostic value of lymphovascular invasion in Bismuth-Corlette type Ⅳ hilar cholangiocarcinoma

引用

World Journal of Gastroenterology 2017年第36期23卷 6685-6693页

作者： Bei Li Xian-Ze Xiong Yong Zhou Si-Jia Wu Zhen You Jiong Lu Nan-Sheng Cheng Department of Biliary Surgery West China Hospital of Sichuan University

AIM To assess the prognostic value of lymphovascular invasion(LVI)in Bismuth-Corlette typeⅣhilar cholangiocarcinoma(HC)patients. METHODS A retrospective analysis was performed on 142consecutively recruited typeⅣHC patients undergoing radical resection with at least 5 years of followup.Survival analysis was performed by the KaplanMeier method,and the association between the clinicopathologic variables and survival was evaluated by log-rank test.Multivariate analysis was adopted to identify the independent prognostic factors for overall survival(OS)and disease-free survival(DFS).Multiple logistic regression analysis was performed to determine the association between LVI and potential variables. RESULTS LVI was confirmed histopathologically in 29(20.4%)patients.Multivariate analysis showed that positive resection margin(HR=6.255,95%CI:3.485-11.229,P30 mm(HR=1.942,95%CI:1.176-3.209,P=0.010)and LVI positivity(HR=2.799,95%CI:1.588-4.935,P30 mm(HR=1.739,95%CI:1.101-2.745,P=0.018)and LVI positivity(HR=2.908,95%CI:1.712-4.938,P30 mm.Multiple logistic regression analysis indicated that N1 stage(HR=3.312,95%CI:1.338-8.198,P=0.026)and tumor size>30 mm(HR=3.258,95%CI:1.288-8.236,P=0.013)were associated with LVI. CONCLUSION LVI is associated with N1 stage and tumor size>30mm and adversely influences DFS and OS in typeⅣHC patients.

关键词： Bismuth-Corlette classification Diseasefree survival Lymphovascular invasion Overall survival hilar cholangiocarcinoma

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization combined with radiotherapy in hilar cholangiocarcinoma

引用

World Journal of Gastrointestinal Oncology 2019年第6期11卷 489-498页

作者： Wen-Heng Zheng Tao Yu Ya-Hong Luo Ying Wang Ye-Fu Liu Xiang-Dong Hua Jie Lin Zuo-Hong Ma Fu-Lu Ai Tian-Lu Wang Department of Medical Imaging Cancer Hospital of China Medical UniversityLiaoning Cancer Hospital and InstituteShenyang 110042Liaoning ProvinceChina Department of Hepatobiliary and Pancreatic Surgery Cancer Hospital of China Medical UniversityLiaoning Cancer Hospital and InstituteShenyang 110042Liaoning ProvinceChina Department of General Surgery (VIP ward) Cancer Hospital of China Medical UniversityLiaoning Cancer Hospital and InstituteShenyang 110042Liaoning ProvinceChina Department of Radiotherapy Cancer Hospital of China Medical UniversityLiaoning Cancer Hospital and InstituteShenyang 110042Liaoning ProvinceChina

BACKGROUND Radical surgical resection is regarded as the best treatment for hepatic hilar cholangiocarcinoma. However, 60%-70% of patients have lost the chance of surgery at the time of diagnosis. Simple biliary stent or drainage tube placement may fail in a short time due to tumor invasion or overgrowth, bile accumulation, or biofilm formation. Effective palliative treatments to extend the effective drainage time are of great significance for improving the quality of life of patients and changing the prognosis of patients. AIM To investigate the clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization (TACE) combined with radiotherapy in hilar cholangiocarcinoma.METHODS A retrospective analysis was conducted on patients clinically diagnosed with hilar cholangiocarcinoma from June 2014 to January 2017 at the Liaoning Provincial Cancer Hospital. Patients were evaluated by specialists, and those who were not suitable for surgery or unwilling to undergo surgery and met the inclusion criteria were included in the study. There were a total of 72 patients (34 males and 38 females) with an average age of 59.9 years (range, 40-72 years). According to percutaneous transhepatic biliary angiography and the patients’ wishes, stent implantation or biliary drainage tube implantation was used to relieve biliary obstruction. The patients were divided into either a control group or a combined treatment group according to their follow-up treatment. The control group consisted of a total of 35 patients who received simple biliary drainage tube placement and biliary stent implantation (7 patients with bilateral stents and 6 with a unilateral stent) and 22 patients receiving biliary drainage tube placement alone. The combined treatment group received TACE and extracorporeal radiotherapy after biliary drainage or biliary stent implantation and consisted of a total of 37 patients, including 21 patients receiving combined treatment after biliary stent placement (14 patients with bilateral stents and

关键词： hilar cholangiocarcinoma Biliary stent Percutaneous biliary drainage Gemcitabine Cisplatin Radiotherapy Transcatheter arterial chemoembolization

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Bilateral vs unilateral placement of metal stents for inoperable highgrade hilar biliary strictures: A systemic review and meta-analysis

引用

World Journal of Gastroenterology 2019年第34期25卷 5210-5219页

作者： Munish Ashat Sumant Arora Jagpal S Klair Christopher A Childs Arvind R Murali Frederick C Johlin Division of Gastroenterology and Hepatology University of Iowa Hospital and ClinicsIowa CityIA 52242United States Section of Gastroenterology SeattleWA 98111United States Hardin Library University of Iowa Hospital and Clinics Iowa CityIA 52242United States

BACKGROUND Bilateral vs unilateral biliary stenting is used for palliation in malignant biliary obstruction.No clear data is available to compare the efficacy and safety of bilateral biliary stenting over unilateral stenting.AIM To assess the efficacy and safety of bilateral vs unilateral biliary drainage in inoperable malignant hilar obstruction.METHODS PubMed,Embase,Scopus,and Cochrane databases,as well as secondary sources(bibliographic review of selected articles and major GI proceedings),were searched through January 2019.The primary outcome was the re-intervention rate.Secondary outcomes were a technical success,early and late complications,and stent malfunction rate.Pooled odds ratio(OR)and 95%confidence interval(CI)were calculated for each outcome.RESULTS A total of 9 studies were included(2 prospective Randomized Controlled Study,5 retrospective studies,and 2 abstracts),involving 782 patients with malignant hilar obstruction.Bilateral stenting had significantly lower re-intervention rate compared with unilateral drainage(OR=0.59,95%CI:0.40-0.87,P=0.009).There was no difference in the technical success rate(OR=0.7,CI:0.42-1.17,P=0.17),early complication rate(OR=1.56,CI:0.31-7.75,P=0.59),late complication rate(OR=0.91,CI:0.58-1.41,P=0.56)and stent malfunction(OR=0.69,CI:0.42-1.12,P=0.14)between bilateral and unilateral stenting for malignant hilar biliary strictures.CONCLUSION Bilateral biliary drainage had a lower re-intervention rate as compared to unilateral drainage for high grade inoperable malignant biliary strictures,with no significant difference in technical success,and early or late complication rates.

关键词： Metal stent hilar biliary stricture Re-intervention rate Technical success rate

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Neoadjuvant therapy in the treatment of hilar cholangiocarcinoma:Review of the literature

引用

World Journal of Gastrointestinal Surgery 2019年第6期11卷 279-286页

作者： Fabio Frosio Federico Mocchegiani Grazia Conte Enrico Dalla Bona ANDrea Vecchi Daniele Nicolini Marco Vivarelli Unit of Hepato-pancreato-biliary and Transplant Surgery Department of Experimental and Clinical Medicine Polytechnic University of Marche

Cholangiocarcinoma(CCA)is a malignant tumor of the biliary system and includes,according to the anatomical classification,intra hepatic CCA(iCCA),hilar CCA(hCCA)and distal CCA(dCCA).hilar CCA is the most challenging type in terms of diagnosis,treatment and prognosis.Surgery is the only treatment possibly providing long-term survival,but only few patients are considered resectable at the time of diagnosis.In fact,tumor’s extension to segmentary or subsegmentary biliary ducts,along with large lymph node involvement or intrahepatic metastases,precludes the surgical approach.To achieve R0 margins is mandatory for the disease-free survival and overall survival.In case of unresectable locally advanced hCCA,radiochemotherapy(RCT)as neoadjuvant treatment demonstrated to be a therapeutic option before either hepatic resection or liver transplantation.Before liver surgery,RCT is believed to enhance the R0 margins rate.For patients meeting the Mayo Clinic criteria,RCT prior to orthotopic liver transplant(OLT)has proved to produce acceptable 5-years survivals.In this review,we analyze the current role of neoadjuvant RCT before resection as well as before OLT.

关键词： hilar cholangiocarcinoma Klatskin tumor Neoadjuvant treatement Radiotherapy Chemotherapy Hepatic resection Liver transplantation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Perineural invasion of hilar cholangiocarcinoma in Chinese population: One center’s experience

引用

World Journal of Gastrointestinal Oncology 2020年第4期12卷 457-466页

作者： Cheng-Gang Li Zhi-Peng Zhou Xiang-Long Tan Zhi-Ming Zhao Second Department of Hepatobiliary Surgery Chinese PLA General HospitalBeijing 100853China

BACKGROUND hilar cholangiocarcinoma(HCCA)often produces perineural invasion(PNI)extending to extra-biliary sites,while significant confusion in the incidence of PNI in HCCA has occurred in the literature,and the mechanism of that procedure remains unclear.AIM To summarize the incidence of PNI in HCCA and to provide the distribution of nerve plexuses around hepatic portal to clinical surgeons.METHODS Reported series with PNI in HCCA since 1996 were reviewed.A clinicopathological study was conducted on sections from 75 patients with HCCA to summarize the incidence and modes of PNI.Immunohistochemical stains for CD34 and D2-40 in the cancer tissue were performed to clarify the association of PNI with microvessel and lymph duct.Sections of the hepatoduodenal ligament from autopsy cases were scanned and handled by computer to display the distribution of nerve plexuses around the hepatic portal.RESULTS The overall incidence of PNI in this study was 92%(69 of 75 patients),while the rate of PNI in HCCA in the literature ranging from 38%to 100%.The incidence of PNI did not show any remarkable differences among various differentiated groups and Bismuth-Corlette classification groups.Logistic regression analysis identified the depth of tumor invasion was the only factor that correlated significantly with PNI(P<0.01).In spite of finding tumor cells that could invade microvessels and lymph ducts in HCCA,we did not find tumor cells invaded nerves via microvessels or lymph ducts.Three nerve plexuses in the hepatoduodenal ligament and Glisson’s sheath were classified,and they all surrounded the great vessels very closely.CONCLUSION The incidence of PNI of HCCA in Chinese population is around 92%and correlated significantly with a depth of tumor invasion.It also should be considered when stratifying HCCA patients for further treatment.

关键词： hilar cholangiocarcinoma Perineural invasion Pathology Nerve plexus Incidence Treatment

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Short-term efficacy of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy via Huang’s three-step maneuver for advanced upper gastric cancer: Results from a propensity scorematched study

引用

World Journal of Gastroenterology 2019年第37期25卷 5641-5654页

作者： Jia-Bin Wang Zhi-Yu Liu Qi-Yue Chen Qing Zhong Jian-Wei Xie Jian-Xian Lin Jun Lu Long-Long Cao Mi Lin Ru-Hong Tu Ze-Ning Huang Ju-Li Lin Hua-Long Zheng Si-Jin Que Chao-Hui Zheng Chang-Ming Huang Ping Li Department of Gastric Surgery Fujian Medical University Union HospitalFuzhou 350001Fujian ProvinceChina Key Laboratory of Ministry of Education of Gastrointestinal Cancer Fujian Medical UniversityFuzhou 350001Fujian ProvinceChina

BACKGROUND Robotic surgery has been considered to be significantly better than laparoscopic surgery for complicated procedures.AIM To explore the short-term effect of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy(SPSHL)for advanced gastric cancer(GC)by Huang’s three-step maneuver.METHODS A total of 643 patients who underwent SPSHL were recruited from April 2012 to July 2017,including 35 patients who underwent robotic SPSHL(RSPSHL)and 608 who underwent laparoscopic SPSHL(LSPSHL).One-to-four propensity score matching was used to analyze the differences in clinical data between patients who underwent robotic SPSHL and those who underwent laparoscopic SPSHL.RESULTS In all,175 patients were matched,including 35 patients who underwent RSPSHL and 140 who underwent LSPSHL.After matching,there were no significant differences detected in the baseline characteristics between the two groups.Significant differences in total operative time,estimated blood loss(EBL),splenic hilar blood loss(SHBL),splenic hilar dissection time(SHDT),and splenic trunk dissection time were evident between these groups(P<0.05).Furthermore,no significant differences were observed between the two groups in the overall noncompliance rate of lymph node(LN)dissection(62.9%vs 60%,P=0.757),number of retrieved No.10 LNs(3.1±1.4 vs 3.3±2.5,P=0.650),total number of examined LNs(37.8±13.1 vs 40.6±13.6,P=0.274),and postoperative complications(14.3%vs 17.9%,P=0.616).A stratified analysis that divided the patients receiving RSPSHL into an early group(EG)and a late group(LG)revealed that the LG experienced obvious improvements in SHDT and length of stay compared with the EG(P<0.05).Logistic regression showed that robotic surgery was a significantly protective factor against both SHBL and SHDT(P<0.05).CONCLUSION RSPSHL is safe and feasible,especially after overcoming the early learning curve,as this procedure results in a radical curative effect equivalent to that of LSPSHL.

关键词： Advanced gastric cancer Robotic surgery Laparoscopic surgery Dissection of splenic hilar lymph node Propensity score matching Huang’s three-step maneuver

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Endoscopic retrograde cholangiopancreatography drainage for palliation of malignant hilar biliary obstruction——stent-in-stent or side-by-side?A systematic review and meta-analysis

引用

World Journal of Hepatology 2021年第5期13卷 595-610页

作者： Gabriel Mayo Vieira de Souza Igor Braga Ribeiro Mateus Pereira Funari Diogo Turiani Hourneaux de Moura Maria Vitória Cury Vieira Scatimburgo João Remíde Freitas Júnior Sergio A Sánchez-Luna Renato Baracat Eduardo Turiani Hourneaux de Moura Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura Gastrointestinal Endoscopy Unit Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-010Brazil Division of Gastroenterology Hepatology and NutritionCenter for Advanced Therapeutic EndoscopyAllegheny Health NetworkPittsburghPA 15212United States Division of Gastroenterology and Hepatology Department of Internal MedicineBasil I.Hirschowitz Endoscopic Center of ExcellenceBirminghamAL 35294United States

BACKGROUND Biliary drainage,either by the stent-in-stent(SIS)or side-by-side(SBS)technique,is often required when treating a malignant hilar biliary obstruction(MHBO).Both methods differ from each other and have distinct advantages.AIM To compare both techniques regarding their efficacy and safety in achieving drainage of MHBO.METHODS A comprehensive search of multiple electronic databases(MEDLINE,Embase,LILACS,BIREME,Cochrane)was conducted and grey literature from their inception until December 2020 with no restrictions regarding the year of publication or language,since there was at least an abstract in English.The included studies compared SIS and SBS techniques through endoscopic retrograde cholangiopancreatography.Outcomes analyzed included technical and clinical success,early and late adverse events(AEs),stent patency,reintervention,and procedure-related mortality.RESULTS Four cohort studies and one randomized controlled trial evaluating a total of 250 patients(127 in the SIS group and 123 in the SBS group)were included in this study.There were no statistically significant differences between the two groups concerning the evaluated outcomes,except for stent patency,which was higher in the SIS compared with the SBS technique[mean difference(d)=33.31;95%confidence interval:9.73 to 56.90,I2=45%,P=0.006].CONCLUSION The SIS method showed superior stent patency when compared to SBS for achieving bilateral drainage in MHBO.Both techniques are equivalent in terms of technical success,clinical success,rates of both early and late AEs,reintervention,and procedure-related mortality.

关键词： Endoscopic retrograde cholangiopancreatography Biliary tract neoplasms Biliary hilar Stenting Drainage

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Left hepatectomy with caudate lobe resection using the methylene blue staining technique for bismuth lllb hilar cholangiocarcinoma

引用

Hepatobiliary Surgery and Nutrition 2019年第6期8卷 674-676页

作者： Ji-Ye Chen Shou-Wang Cai Zhi-Wei Liu Xian-Lei Xing Hospital and Institute of Hepatobiliary Surgery Chinese PLA General HospitalChinese PLA Postgraduate Medical SchoolBeijing 100853China

Left hepatectomy with caudate lobe resection has been widely accepted as the standard treatment for bismuth IIIb hilar cholangiocarcinoma(1-6).However,there is no clear boundary between the right caudate lobe and the right posterior section.The methylene blue staining technique are commonly used to delineate the margin of the relevant hepatic segment for anatomic hepatectomy(7).Herein,we described this technique to demarcate the boundary between the caudate lobe and the right posterior lobe for an en bloc resection of the tumor and improve the R0 surgical margin.

关键词： resection hepatectomy hilar

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Editorial on“Perihilar Cholangiocarcinoma-Novel Benchmark Values for Surgical and Oncological Outcomes From 24 Expert Centers”

引用

Hepatobiliary Surgery and Nutrition 2022年第3期11卷 422-424页

作者： Shivan Sivakumar Flavio GRocha Lara Heij Department of Oncology University of OxfordOxfordUK Division of Surgical Oncology Knight Cancer InstituteOregon Health and Science UniversityPortlandORUSA Department of Surgery and Transplantation University Hospital RWTH AachenAachenGermany Institute of Pathology University Hospital RWTH AachenAachenGermany

Cholangiocarcinoma(CCA)is a rare and very aggressive malignancy arising from the biliary tract.Based on the location of the tumor,CCA can be divided in intrahepatic cholangiocarcinoma(iCCA),perihilar cholangiocarcinoma(pCCA)and distal cholangiocarcinoma(dCCA).Many other characteristics differentiate these groups,including pathological features,oncological approach and surgical techniques,which in turn influences patient outcomes.

关键词： hilar carcinoma Surgical

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：