浅谈肝lI-1部胆管癌外科治疗中的争议.PDF

生堡趟丝之E社盘查垫!Q生垒旦筮!鲞笙i期￡!也』墅ig塾!堡：』坚塑垫!Q：Y!!：!：№：2 ·165· ·述评· 肝lI-1部胆管癌外科治疗中的争议 董家鸿项灿宏孟翔飞 in ofhilar surgical Controversytherapy cholangiocardnoma 的进展范围是首先关注的问题。由于肿瘤上游侧的 DONG Jia一，阳昭，XIANGCan-，m昭，MENGXiang-fei．Research 浸润常深入肝内，这给术前的评估和手术规划的制 Institute PLA．General ofHepatobiliarySurgeryof Hospitalof 100853，China PLA，Beifing computed Correspondingauthor：DONG肋一J幻愕，Emall：,i,mIch301@ J63．corn 重建(multipleplanar the for of 1980s，indicationsresection 【Abstract】Since 和管壁组织的信息同时存在，有利于对癌细胞浸润 hilar have cholangiocarcinomaprogressivelyimpmved．Operation 范围的判断。对造影后增强的胆管癌，有76％的上 is to other modalitieswith to superiorany therapeutic regard survivalrateand of 游侧胆管浸润范围可被正确评估【3l。而MDCT结 qualitylife．Currently，hepaticlobectomy， extended bileduct 合x线造影评估肝门部胆管癌胆管浸润范围的准 hepaticlobectomy，extrahepaticresection， andRoux·en·Y regionallymphadenectomy jejunos· reso- hepatoenteric 确性可达84％14 J。核磁胆道水成像(magnetic titlerecommended船thetreatmentofchoiceformost tomy nance withhilar patients cholangiocareinoma．However，controversy 生直观了解胆管树的解剖和肿瘤的进展范围，但丢 ofhilar stillmmains the andtreatment regardingdiagnosis theassessmentof 失了胆管壁的软组织信号，且对细小胆管支和管壁 longitudinal cholangiocarcinoma，including tumor eva