摘要
目的探讨可手术切除的肝门部胆管癌术前胆道引流的利弊、术前胆道引流的时机及各种引流方式的特点。方法通过查阅近20年来国内外相关文献,对可手术切除的肝门部胆管癌术前胆道引流治疗相关争议、术前胆道引流时机及各种引流方式进行综述。结果对于可手术切除的肝门部胆管癌是否需常规行术前胆道引流尚存在很大争议,但对于术前胆道引流时机有较一致的共识,且各种引流方式各有特点。结论肝门部胆管癌主要治疗方式为根治性外科手术切除,但常因胆道恶性梗阻引起胆汁淤积,为围手术期管理带来难度。对于可手术切除的肝门部胆管癌患者是否需常规行术前胆道引流治疗仍需大量前瞻性研究提供更多证据。
Objective To explore the advantages and disadvantages of preoperative biliary drainage,the timing of preoperative biliary drainage,and the characteristics of various drainage methods for resectable hilar cholangiocarcinoma.Methods By reviewing relevant literatures at home and abroad in the past 20 years,the controversies related to the preoperative biliary drainage,surgical biliary drainage,and various drainage methods for resectable hilar cholangiocarcinoma were reviewed.Results There is still a great deal of controversy about whether preoperative bile duct drainage is required for resectable hilar cholangiocarcinoma routinely,but there is a consensus on the timing of preoperative biliary drainage,and various drainage methods have their own characteristics.Conclusions The main treatment for hilar cholangiocarcinoma is radical surgical resection,but cholestasis is often caused by malignant biliary obstruction,which makes it difficult to manage perioperatively.A large number of prospective studies are needed to provide more evidence for the need for routine preoperative biliary drainage in patients with hilar cholangiocarcinoma who can undergo resection.
作者
叶正陈
陈晓星
王琳
YE Zhengchen;Chen Xiaoxing;WANG Lin(Hepatopancreatobiliary Surgery Dept.2,Second Affiliated Hospital of Kunming Medical University,Kunming 650106,R.P.China)
出处
《中国普外基础与临床杂志》
CAS
2020年第6期763-767,共5页
Chinese Journal of Bases and Clinics In General Surgery
