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Концептуальные аспекты хирургического лечения воротной холангиокарциномы

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Целью данной статьи является отражение современных подходов к хирургическому лечению воротной холангиокарциномы. Радикальная операция (RG-резекция) должна быть основной целью лечения. В настоящее время резекция I сегмента и части IV сегмента печени в сочетании с правосторонней или левосторонней гемигепатэктомией, резекцией внепеченочных желчных протоков, лимфодиссекция гепатодуоденальной связки и в некоторых случаях сосудистая резекция являются стандартом хирургического лечения опухоли Клацкина. В последнее время малая резекция печени как операция выбора была предложена для лечения этого заболевания. Однако безопасность и эффективность такого подхода являются спорными. Кроме того, на сегодняшний день нет консенсуса в отношении резектабельности опухоли у пациентов с местнораспространенной воротной холангиокарциномой.

Ключевые слова:
оротная холангиокарцинома, хирургическое лечение, hilar cholangiocarcinoma, surgical treatment

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Surgical Treatment of Hilar Cholangiocarcinoma (Review)

The aim of this article is to describe the modem surgical approaches for hilar cholangiocarcinoma management. R0-resection should be the main goal of treatment. At present time resection of the caudate lobe and the part of segment IV combined with right- or left-sided hepatectomy, bile duct resection, lymphadenectomy of the hepatic hilum and sometimes vascular resection is the standard surgical procedure for Klatskin tumors. More recently minor liver resections have been proposed for treatment of this tumor. However, the safety and effectiveness of this approach are controversial. Moreover, there is no consensus for patients with locally advanced hilar cholangiocarcinoma.

Keywords:
оротная холангиокарцинома, хирургическое лечение, hilar cholangiocarcinoma, surgical treatment