肝胰十二指肠切除术在中晚期胆囊癌治疗中的应用

张海文; 王蒙; 王传磊; 解恩博; 王广义

doi:10.3969/j.issn.1001-5256.2017.07.043

肝胰十二指肠切除术在中晚期胆囊癌治疗中的应用

DOI: 10.3969/j.issn.1001-5256.2017.07.043

吉林大学第一医院肝胆胰外一科

详细信息

中图分类号: R735.8
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出版历程
- 收稿日期: 2017-01-03
- 出版日期: 2017-07-20

Clinical application of hepatopancreatoduodenectomy in treatment of advanced gallbladder cancer

First Department of Hepatopancreatobiliary Surgery, The First Hospital of Jilin University

摘要

摘要: 胆囊癌进展迅速,早期诊断较为困难,R0切除率低,预后较差。近年来有不少大型医疗中心对累及胆总管、十二指肠、门静脉等而无远处转移的中晚期胆囊癌患者施行包括肝胰十二指肠切除术(HPD)在内的扩大根治术,显著提高了R0切除率,延长了患者生存期,但由于HPD的高并发症和病死率,不少外科医生依然对此缺乏信心。就HPD在中晚胆囊癌中的应用现状﹑存在的问题﹑并发症和手术指征等问题进行了综述,认为在严格选择患者及把握手术适应证的基础上,HPD是可行的。
- 胆囊肿瘤 /
- 肝胰十二指肠切除术 /
- 治疗结果 /
- 综述
Abstract: Gallbladder cancer has many characteristics such as rapid progression, difficult early diagnosis, low R0 resection rate, and poor prognosis.In recent years, extended radical resections including hepatopancreatoduodenectomy (HPD) have been performed for patients with advanced gallbladder carcinoma that invades the common bile duct, duodenum, and portal vein, but with no distant metastasis in many large medical centers.This procedure can significantly increase the R0 resection rate and prolong the survival time of patients.But due to the high rate of complications and high mortality in the patients treated with HPD, many surgeons still have little confidence in this procedure.This article reviews the current application of HPD in advanced gallbladder cancer, related problems, complications, and surgical indications, and suggests that HPD can be selected according to strict surgical indications.
- gallbladder neoplasms /
- hepatopancreatoduodenectomy /
- treatment outcome /
- review

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参考文献(19)

[1]THOMAS A, NICOLAS J, MILIND J, et al.Gallbladder Cancer:expert consensus statement[J].HBP, 2015, 17 (8) :681-690.

[2]JIN LX, PITT SC, HALL BL, et al.Aggressive surgical management of gallbladder cancer:at what cost?[J].Surgery, 2013, 154 (2) :266-273.

[3]SONG HW, SHEN HX, CHEN C, et al.Gallbladder cancer:a comprehensive review on basic research[J].Chin J Hepatobiliary Surg, 2015, 21 (8) :574-576. (in Chinese) 宋虎伟, 慎浩鑫, 陈晨, 等.胆囊癌相关基础研究进展[J].中华肝胆外科杂志, 2015, 21 (8) :574-576.

[4]ZHOU YM, ZHANG ZB, WU LP, et al.A systematic review of safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers[J].HBP, 2016, 18 (1) :1-6.

[5]SHIRAI Y, WAKAI T, SAKATA J, et al.Regional lymphadenectomy for gallbladder cancer:Rational extent, technical details, and patient outcomes[J].World J Gastroenterol, 2012, 18 (22) :2775-2783.

[6]KASUMI F, TAGAGI K, KONISHI T, et al.Surgical treatment of carcinoma of the gallbladder, analyzing its modes of spread (in Japanses) [J].Nippon Shokaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) , 1976, 9 (3) :170-177.

[7]YUJI K, AKIHIRO Y, MASATOSHI I, et al.Survival benefit of hepatopancreatoduodenectomy for cholangiocarcinoma in comparison to hepatectomy or pancreatoduodenectomy[J].World J Surg, 2010, 34 (11) :2662-2670.

[8]LIM CS, JANG JY, LEE SE, et al.Reappraisal of hepatopancreatoduodenectomy as a treatment modality for bile duct and gallbladder cancer[J].J Gastrointest Surg, 2012, 16 (5) :1012-1018.

[9]TOMOKI E, YUKIHIRO Y, TSUYOSHI I, et al.Review of hepatopancreatoduodenectomy for biliary cancer:an extended radical approach of Japanese origin[J].J Hepatobiliary Pancreat Sci, 2014, 21 (8) :550-555.

[10]YUSUKE Y, TEIICHI S, YUKIYASU O, et al.Is combined pancreatoduodenectomy for advanced gallbladder cancer justified?[J].Surgery, 2016, 159 (3) :810-820.

[11]FERNANDES EDSM, MELLO FT, RIBEIRO-FILHO J, et al.The largest western experience with hepatopancreatoduodenectomy:lessons learned with 35 cases[J].Arq Bras Cir Dig, 2016, 29 (1) :17-20.

[12]YUJI K, AKIHIRO Y, MASATOSHI I, et al.Hepatopancreatoduodenectomy:its suitability for bile duct cancer versus gallbladder cancer[J].J Hepatobiliary Pancreat Surg, 2007, 14 (2) :142-148.

[13]TOMOKI E, MASATO N, HIDEKI N, et al.Right hepatopancreatoduodenectomy:improvements over 23 years to attain acceptability[J].J Hepatobiliary Pancreat Surg, 2007, 14 (2) :131-135.

[14]YOSHIHIRO S, SATOSHI N, YOJI K, et al.Is extended hemihepatectomy plus pancreaticoduodenectomy justified for advanced bile duc cancer and gallbladder cancer[J].Surgery, 2013, 153 (6) :794-800.

[15]Biliary Surgery Group of Surgery Branch of Chinese Medical Association.Guideline for the diagnosis and treatment of gallbladder carcinoma (2015 edition) [J].J Clin Hepatol, 2016, 32 (3) :411-419. (in Chinese) 中华医学会外科学分会胆道外科学组.胆囊癌诊断和治疗指南 (2015版) [J].临床肝胆病杂志, 2016, 32 (3) :411-419.

[16]SANTOSH KS, RAJNISH T, NARAYANAN K, et al.Aggressive surgical approach for gallbladder cancer:a single-center experience from northern India[J].J Gastrointest Cancer, 2015, 46 (4) :399-407.

[17]LI JJ, LI W, QU Q, et al.Clinical assessment using TNM staging for 151 patients with gallbladder carcinoma[J].Chin J Hepatobiliary Surg, 2014, 20 (7) :507-510. (in Chinese) 李静静, 李卫, 曲强, 等.胆囊癌患者151例新版TNM分期的临床评估[J].中华肝胆外科杂志, 2014, 20 (7) :507-510.

[18]FANG Y, GURUSAMY KS, WANG Q, et al.Meta-analysis o randomized clinical trials on safety and efficacy of biliary drainage before surgery for obstructive jaundice[J].Br J Surg, 2013, 100 (12) :1589-1596.

[19]ZHANG MZ, XU XW, MOU YP, et al.Resection of a cholangiocarcinoma via laparoscopic hepatopancreato-duodenectomy:A case report[J].World J Gastroenterol, 2014, 20 (45) :17260-17264.

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