摘要
肝门部胆管癌(hilar cholangiocarcinoma,HCCA)是胆道系统常见的恶性肿瘤,联合血管切除重建的HCCA根治术有助于获得R0切除,提高肿瘤可切除性,改善病人预后。随着腹腔镜和机器人等微创手术技术的不断普及,越来越多中心也开始尝试开展微创下联合血管切除重建的HCCA根治手术。受限于肝门部解剖复杂性与微创技术的局限性,在微创条件下完成HCCA的血管切除重建尤为困难。我们在微创HCCA根治术中积累了一定的血管切除重建经验,本文将从微创HCCA血管切除重建技术挑战、适应证选择、成熟重建技术方法、重建技巧及重建失败后的补救措施进行阐述。
Hilar cholangiocarcinoma(HCCA)is a common malignant tumor of the biliary system.Radical HCCA resection with combined vascular resection and reconstruction can help achieve R0 resection,improve tumor resectability,and enhance patient outcomes.With the increasing popularity of minimally invasive surgical techniques such as laparoscopy and robotic surgery,more and more centers are beginning to experiment with minimally invasive HCCA resection with combined vascular resection and reconstruction.However,due to the complex anatomy of the hilum and the limitations of minimally invasive techniques,completing HCCA revascularization and reconstruction under minimally invasive conditions is particularly challenging.The author has accumulated considerable experience in minimally invasive HCCA vascular resection and reconstruction.This article will discuss the technical challenges of minimally invasive HCCA vascular resection and reconstruction,indication selection,established revascularization techniques,reconstructive skills,and remedial measures after reconstruction failure.
作者
陈卫波
杨洋
赵国栋
CHEN Weibo;YANG Yang;Zhao Guodong(Department of Hepatopancreatobiliary Surgery,the Third Affiliated Hospital of Soochow University,Changzhou,213003,China;不详)
出处
《临床外科杂志》
2025年第7期673-676,共4页
Journal of Clinical Surgery
基金
国家自然科学基金项目(82303005)
常州市卫健委重大科技项目(ZD202305)
常州市“十四五”卫生健康高层次人才培养工程项目(2022260-67)。
关键词
肝门部胆管癌
血管切除重建
微创手术
hilar cholangiocarcinoma
vascular resection and reconstruction
minimally invasive surgery
