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中华肝脏外科手术学电子杂志 doi: 10.3877/cma.j.issn.2095-3232.2024996

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肝胰十二指肠切除术在胆囊癌和胆管癌应用中的关键问题
林科灿1,(), 罗柳平2   
  1. 1. 350006 福州,福建医科大学附属第一医院肝胆胰外科
    2. 350046 福州,福建医科大学孟超肝胆医院肝胆胰外科
  • 收稿日期:2024-06-10
  • 通信作者: 林科灿
  • 基金资助:
    福建省自然科学基金(2020J011161)

Key problems in the application of hepatopancreaticoduodenectomy for gallbladder cancer and cholangiocarcinoma

Kecan Lin1,(), Liuping Luo2   

  1. 1. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350006, China
    2. Department of Hepatobiliary and Pancreatic Surgery, Meng Chao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350046, China
  • Received:2024-06-10
  • Corresponding author: Kecan Lin
引用本文:

林科灿, 罗柳平. 肝胰十二指肠切除术在胆囊癌和胆管癌应用中的关键问题[J]. 中华肝脏外科手术学电子杂志, doi: 10.3877/cma.j.issn.2095-3232.2024996.

Kecan Lin, Liuping Luo. Key problems in the application of hepatopancreaticoduodenectomy for gallbladder cancer and cholangiocarcinoma[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), doi: 10.3877/cma.j.issn.2095-3232.2024996.

胆囊癌和胆管癌患者预后较差,手术切除是治愈的唯一机会。肝胰十二指肠手术(HPD)是胆囊癌和胆管癌肿瘤广泛扩散、浸润肝门和胰腺段胆管的唯一根治性手术方式。然而由于其死亡率和并发症发生率较高,生存获益有争议,其开展范围有限。虽然近年来该手术的围手术期死亡率逐渐下降,生存率也有所提高,但HPD仍未成为局部进展期胆囊癌和胆管癌患者的普遍手术选择。本文主要阐述HPD在胆囊癌和胆管癌中应用的适应证、关键技术、安全性和疗效。

Patients with gallbladder cancer and cholangiocarcinoma have poor prognosis, and surgical resection is the final option. Hepatopancreatoduodenectomy (HPD) is the only radical surgical treatment for gallbladder cancer and cholangiocarcinoma patients with tumor widely spread and infiltrating the hilum and pancreatic bile duct. However, the application scope of HPD is limited due to high mortality and complication rates and uncertain survival benefits. Although perioperative mortality of HPD has been gradually decreased and survival rate has been improved in recent years, HPD has not become a common surgical procedure for patients with locally advanced gallbladder cancer and cholangiocarcinoma. In this article, the indications, key techniques, safety and efficacy of HPD in gallbladder cancer and cholangiocarcinoma were explicitly illustrated.

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