Выход
Вход/Login
 
E-mail
Пароль/Password
Забыли пароль?
Введите E-mail и жмите тут. Пароль будет выслан на указанный адрес
Войти (LogIn)

 

Если вы первый раз здесь, то зарегистрируйтесь

Регистрация/Sign Up
Полное имя (Ф И О)/Full name
E-mail
Телефон/Phone
Зарегистрироваться,
на ваш E-mail будет выслан временный пароль

 

Медицинская литература. Новинки


 

 

 

 

 
вce журналы << Анналы хирургической гепатологии << 2017 год << №4 <<
стр.72
отметить
статью

Концептуальные аспекты хирургического лечения воротной холангиокарциномы

Коваленко Ю. А., Жариков Ю. О.
Вы можете загрузить полный текст статьи в формате pdf
Коваленко Юрий Алексеевич - канд. мед. наук, старший научный сотрудник отдела абдоминальной хирургии, отделения хирургической гепатологии и панкреатологии ФГБУ “Институт хирургии им. А.В. Вишневского” Минздрава России, ФГБУ “Институт хирургии им. А.В. Вишневского” Министерства здравоохранения Российской Федерации, 117997, г. Москва, ул. Большая Серпуховская, д. 27, Российская Федерация
Жариков Юрий Олегович - канд. мед. наук, врач-хирург отдела абдоминальной хирургии, отделения хирургической гепатологии и панкреатологии ФГБУ “Институт хирургии им. А.В. Вишневского” Минздрава России, ФГБУ “Институт хирургии им. А.В. Вишневского” Министерства здравоохранения Российской Федерации, dr_zharikov@mail.ru, 117997, г. Москва, ул. Большая Серпуховская, д. 27, Российская Федерация

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

Литература:
1.Igami T., Nishio H., Ebata T., Yokoyama Y., Sugawara G., Nimura Y., Nagino M. Surgical treatment of hilar cholangiocarcinoma in the “new era”: the Nagoya University experience. J. Hepatobiliary Pancreat. Sci. 2010; 17 (4): 449-454. DOI: 10.1007/s00534-009-0209-0.
2.Nimura Y., Hayakawa N., Kamiya J., Kondo S., Shionoya S. Hepatic segmentectomy with caudate lobe resection for bile duct carcinoma of the hepatic hilus. World J. Surg. 1990; 14 (4): 535-543; discussion 544.
3.Ebata T., Kosuge T., Hirano S., Unno M., Yamamoto M., Miyazaki M., Kokudo N., Miyagawa S., Takada T., Nagino M. Proposal to modify the International Union Against Cancer staging system for perihilar cholangiocarcinomas. Br. J. Surg. 2014; 101 (2): 79-88. DOI: 10.1002/bjs.9379.
4.Котенко О.Г., Попов А.О., Коршак А.А., Гриненко А.В., Гусев А.В., Федоров Д.А., Григорян М.С. Хирургическое лечение хилярной холангиокарциномы с инвазией в воротную вену. Украинский журнал хирургии. 2013; 22 (3): 7-13.
5.Neuhaus P., Thelen A., Jonas S., Puhl G., Denecke T., Veltzke-Schlieker W., Seehofer D. Oncological superiority of hilar en bloc resection for the treatment of hilar cholangiocarcinoma. Ann. Surg. Oncol. 2012; 19 (5): 1602-1608. DOI: 10.1245/s10434-011-2077-5.
6.Hemming A.W., Reed A.I., Fujita S., Foley D.P., Howard R.J. Surgical management of hilar cholangiocarcinoma. Ann. Surg. 2005; 241 (5): 693-699; discussion 699-702.
7.Ribero D., Amisano M., Lo Tesoriere R., Rosso S., Ferrero A., Capussotti L. Additional resection of an intraoperative marginpositive proximal bile duct improves survival in patients with hilar cholangiocarcinoma. Ann. Surg. 2011; 254 (5): 776-781; discussion 781-783. DOI: 10.1097/SLA.0b013e3182368f85.
8.Ito F., Cho C.S., Rikkers L.F., Weber S.M. Hilar cholangiocarcinoma: current management. Ann. Surg. 2009; 250 (2): 210-218. DOI: 10.1097/SLA.0b013e3181afe0ab.
9.Lee J.H., Hwang D.W., Lee S.Y., Park K.M., Lee Y.J. The proximal margin of resected hilar cholangiocarcinoma: the effect of microscopic positive margin on long-term survival. Am. Surg. 2012; 78 (4): 471-477.
10.Seyama Y., Kubota K., Sano K., Noie T., Takayama T., Kosuge T., Makuuchi M. Long-term outcome of extended hemihepatectomy for hilar bile duct cancer with no mortality and high survival rate. Ann. Surg. 2003; 238 (1): 73-83.
11.Otto G., Hoppe-Lotichius M., Bittinger F., Schuchmann M., Düber C. Klatskin tumour: meticulous preoperative work-up and resection rate. Z. Gastroenterol. 2011; 49 (4): 436-442. DOI: 10.1055/s-0029-1246011.
12.Xiang S., Lau W.Y., Chen X.P. Hilar cholangiocarcinoma: controversies on the extent of surgical resection aiming at cure. Int. J. Colorectal. Dis. 2015; 30 (2): 159-171. DOI: 10.1007/s00384-014-2063-z.
13.Endo I., House M.G., Klimstra D.S., Gönen M., D''Angelica M., Dematteo R.P., Fong Y., Blumgart L.H., Jarnagin W.R. Clinical significance of intraoperative bile duct margin assessment for hilar cholangiocarcinoma. Ann. Surg. Oncol. 2008; 15 (8): 2104-2112. DOI: 10.1245/s10434-008-0003-2.
14.Ebata T., Watanabe H., Ajioka Y., Oda K., Nimura Y. Pathological appraisal of lines of resection for bile duct carcinoma. Br. J. Surg. 2002; 89 (10): 1260-1267.
15.Sakamoto E., Nimura Y., Hayakawa N., Kamiya J., Kondo S., Nagino M., Kanai M., Miyachi M., Uesaka K. The pattern of infiltration at the proximal border of hilar bile duct carcinoma: a histologic analysis of 62 resected cases. Ann. Surg. 1998; 227 (3): 405-411.
16.Okazaki Y., Horimi T., Kotaka M., Morita S., Takasaki M. Study of the intrahepatic surgical margin of hilar bile duct carcinoma. Hepatogastroenterology. 2002; 49 (45): 625-627.
17.de Jong M.C., Marques H., Clary B.M., Bauer T.W., Marsh J.W., Ribero D., Majno P., Hatzaras I., Walters D.M., Barbas A.S., Mega R., Schulick R.D., Choti M.A., Geller D.A., Barroso E., Mentha G., Capussotti L., Pawlik T.M. The impact of portal vein resection on outcomes for hilar cholangiocarcinoma: a multi-institutional analysis of 305 cases. Cancer. 2012; 118 (19): 4737-4747. DOI: 10.1002/cncr.27492.
18.Lee S.G., Song G.W., Hwang S., Ha T.Y., Moon D.B., Jung D.H., Kim K.H., Ahn C.S., Kim M.H., Lee S.K., Sung K.B., Ko G.Y. Surgical treatment of hilar cholangio carcinoma in the new era: the Asan experience. J. Hepatobiliary Pancreat. Sci. 2010; 17 (4): 476-489. DOI: 10.1007/s00534-009-0204-5.
19.Kow A.W., Wook C.D., Song S.C., Kim W.S., Kim M.J., Park H.J., Heo J.S., Choi S.H. Role of caudate lobectomy in type III A and III B hilar cholangiocarcinoma: a 15-year experience in a tertiary institution. World J. Surg. 2012; 36 (5): 1112-1121. DOI: 10.1007/s00268-012-1497-0.
20.Li H., Qin Y., Cui Y., Chen H., Hao X., Li Q. Analysis of the surgical outcome and prognostic factors for hilar cholangiocarcinoma: a Chinese experience. Dig. Surg. 2011; 28 (3): 226-231. DOI: 10.1159/000327361.
21.Bismuth H., Nakache R., Diamond T. Management strategies in resection for hilar cholangiocarcinoma. Ann. Surg. 1992; 215 (1): 31-38.
22.Schiffman S.C., Reuter N.P., McMasters K.M., Scoggins C.R., Martin R.C. Overall survival peri-hilar cholangiocarcinoma: R1 resection with curative intent compared to primary endoscopic therapy. J. Surg. Oncol. 2012; 105 (1): 91-96. DOI: 10.1002/jso.22054.
23.Shingu Y., Ebata T., Nishio H., Igami T., Shimoyama Y., Nagino M. Clinical value of additional resection of a marginpositive proximal bile duct in hilar cholangiocarcinoma. Surgery. 2010; 147 (1): 49-56. DOI: 10.1016/j.surg.2009.06.030.
24.Zervos E.E., Pearson H., Durkin A.J., Thometz D., Rosemurgy P., Kelley S., Rosemurgy A.S. In-continuity hepatic resection for advanced hilar cholangiocarcinoma. Am. J. Surg. 2004; 188 (5): 584-588. DOI: 10.1016/j.amjsurg.2004.07.035.
25.Blumgart L.H., Hadjis N.S., Benjamin I.S., Beazley R. Surgical approaches to cholangiocarcinoma at confluence of hepatic ducts. Lancet. 1984; 1 (8368): 66-70.
26.Baer H.U., Stain S.C., Dennison A.R., Eggers B., Blumgart L.H. Improvements in survival by aggressive resections of hilar cholangiocarcinoma. Ann. Surg. 1993; 217 (1): 20-27.
27.Bengmark S., Ekberg H., Evander A., Klofver-Stahl B., Tranberg K.G. Major liver resection for hilar cholangiocarcinoma. Ann. Surg. 1988; 207 (2): 120-125.
28.Boerma E.J. Research into the results of resection of hilar bile duct cancer. Surgery. 1990; 108 (3): 572-580.
29.Вишневский В.А., Тарасюк Т.И. Диагностика и хирургическое лечение рака проксимальных печеночных протоков (опухолей Клатскина). Практическая онкология. 2004; 5 (2): 126-134.
30.Cho A., Yamamoto H., Kainuma O., Muto Y., Yanagibashi H., Tonooka T., Masuda T. Laparoscopy in the management of hilar cholangiocarcinoma. World J. Gastroenterol. 2014; 20 (41): 15153-15157. DOI: 10.3748/wjg.v20.i41.15153.
31.Cannon R.M., Brock G., Buell J.F. Surgical resection for hilar cholangiocarcinoma: experience improves resectability. HPB (Oxford). 2012; 14 (2): 142-149. DOI: 10.1111/j.1477-2574.2011.00419.x.
32.Nuzzo G., Giuliante F., Ardito F., Giovannini I., Aldrighetti L., Belli G., Bresadola F., Calise F., Dalla Valle R., D''Amico D.F., Gennari L., Giulini S.M., Guglielmi A., Jovine E., Pellicci R., Pernthaler H., Pinna A.D., Puleo S., Torzilli G., Capussotti L.; Italian Chapter of the International Hepato-Pancreato-Biliary Association, Cillo U., Ercolani G., Ferrucci M., Mastrangelo L., Portolani N., Pulitanò C., Ribero D., Ruzzenente A., Scuderi V., Federico B. Improvement in perioperative and long-term outcome after surgical treatment of hilar cholangiocarcinoma: results of an Italian multicenter analysis of 440 patients. Arch. Surg. 2012; 147 (1): 26-34. DOI: 10.1001/archsurg.2011.771.
33.van Gulik T.M., Kloek J.J., Ruys A.T., Busch O.R., van Tienhoven G.J., Lameris J.S., Rauws E.A., Gouma D.J. Multidisciplinary management of hilar cholangiocarcinoma (Klatskin tumor): extended resection is associated with improved survival. Eur. J. Surg. Oncol. 2011; 37 (1): 65-71. DOI: 10.1016/j.ejso.2010.11.008.
34.Rocha F.G., Matsuo K., Blumgart L.H., Jarnagin W.R. Hilar cholangiocarcinoma: the Memorial Sloan-Kettering Cancer Center experience. J. Hepatobiliary Pancreat. Sci. 2010; 17 (4): 490-496. DOI: 10.1007/s00534-009-0205-4.
35.Ikeyama T., Nagino M., Oda K., Ebata T., Nishio H., Nimura Y. Surgical approach to Bismuth type I and II hilar cholangiocarcinomas: audit of 54 consecutive cases. Ann. Surg. 2007; 246 (6): 1052-1057.
36.Cho M.S., Kim S.H., Park S.W., Lim J.H., Choi G.H., Park J.S., Chung J.B., Kim K.S. Surgical outcomes and predicting factors of curative resection in patients with hilar cholangiocarcinoma: 10-year single-institution experience. J. Gastrointest. Surg. 2012; 16 (9): 1672-1679. DOI: 10.1007/s11605-012-1960-0.
37.Young A.L., Prasad K.R., Toogood G.J., Lodge J.P. Surgical treatment of hilar cholangiocarcinoma in a new era: comparison among leading Eastern and Western centers, Leeds. J. Hepatobiliary Pancreat. Sci. 2010; 17 (4): 497-504. DOI: 10.1007/s00534-009-0203-6.
38.Hirano S., Kondo S., Tanaka E., Shichinohe T., Tsuchikawa T., Kato K., Matsumoto J., Kawasaki R. Outcome of surgical treatment of hilar cholangiocarcinoma: a special reference to postoperative morbidity and mortality. J. Hepatobiliary Pancreat. Sci. 2010; 17 (4): 455-462. DOI: 10.1007/s00534-009-0208-1.
39.Konstadoulakis M.M., Roayaie S., Gomatos I.P., Labow D., Fiel M.I., Miller C.M., Schwartz M.E. Aggressive surgical resection for hilar cholangiocarcinoma: is it justified? Audit of a single center''s experience. Am. J. Surg. 2008; 196 (2): 160-169. DOI: 10.1016/j.amjsurg.2007.07.033.
40.Tan J.W., Hu B.S., Chu Y.J., Tan Y.C., Ji X., Chen K., Ding X.M., Zhang A., Chen F., Dong J.H. One-stage resection for Bismuth type IV hilar cholangiocarcinoma with high hilar resection and parenchyma-preserving strategies: a cohort study. World J. Surg. 2013; 37 (3): 614-621. DOI: 10.1007/s00268-012-1878-4.
41.Song S.C., Choi D.W., Kow A.W., Choi S.H., Heo J.S., Kim W.S., Kim M.J. Surgical outcomes of 230 resected hilar cholangiocarcinoma in a single centre. ANZ J. Surg. 2013; 83 (4): 268-274. DOI: 10.1111/j.1445-2197.2012.06195.x.
42.Kawasaki S., Imamura H., Kobayashi A., Noike T., Miwa S., Miyagawa S. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization. Ann. Surg. 2003; 238 (1): 84-92.
43.Hadjis N.S., Blenkharn J.I., Alexander N., Benjamin I.S., Blumgart L.H. Outcome of radical surgery in hilar cholangiocarcinoma. Surgery. 1990; 107 (6): 597-604.
44.Mizumoto R., Kawarada Y., Suzuki H. Surgical treatment of hilar carcinoma of the bile duct. Surg. Gynecol. Obstet. 1986; 162 (2): 153-158.
45.Ogura Y., Mizumoto R., Tabata M., Matsuda S., Kusuda T. Surgical treatment of carcinoma of the hepatic duct confluence: analysis of 55 resected carcinomas. World J. Surg. 1993; 17 (1): 85-92; discussion 92-93.
46.Gazzaniga G.M., Ciferri E., Bagarolo C., Filauro M., Bondanza G., Fazio S., Ermili F. Primitive hepatic hilum neoplasm. J. Surg. Oncol. Suppl. 1993; 3: 140-146.
47.Cheng Q.B., Yi B., Wang J.H., Jiang X.Q., Luo X.J., Liu C., Ran R.Z., Yan P.N., Zhang B.H. Resection with total caudate lobectomy confers survival benefit in hilar cholangiocarcinoma of Bismuth type III and IV. Eur. J. Surg. Oncol. 2012; 38 (12): 1197-1203. DOI: 10.1016/j.ejso.2012.08.009.
48.Sugiura Y., Nakamura S., Iida S., Hosoda Y., Ikeuchi S., Mori S., Sugioka A., Tsuzuki T. Extensive resection of the bile ducts combined with liver resection for cancer of the main hepatic duct junction: a cooperative study of the Keio Bile Duct Cancer Study Group. Surgery. 1994; 115 (4): 445-451.
49.Dumitrascu T., Chirita D., Ionescu M., Popescu I. Resection for hilar cholangiocarcinoma: analysis of prognostic factors and the impact of systemic inflammation on long-term outcome. J. Gastrointest. Surg. 2013; 17 (5): 913-924. DOI: 10.1007/s11605-013-2144-2.
50.Jonas S., Benckert C., Thelen A., Lopez-Hänninen E., Rösch T., Neuhaus P. Radical surgery for hilar cholangiocarcinoma. Eur. J. Surg. Oncol. 2008; 34 (3): 263-271. DOI: 10.1016/j.ejso.2007.09.024.
51.Witzigmann H., Berr F., Ringel U., Caca K., Uhlmann D., Schoppmeyer K., Tannapfel A., Wittekind C., Mossner J., Hauss J., Wiedmann M. Surgical and palliative management and outcome in 184 patients with hilar cholangiocarcinoma: palliative photodynamic therapy plus stenting is comparable to r1/r2 resection. Ann. Surg. 2006; 244 (2): 230-239. DOI: 10.1097/01.sla.0000217639.10331.47.
52.Rea D.J., Munoz-Juarez M., Farnell M.B., Donohue J.H., Que F.G., Crownhart B., Larson D., Nagorney D.M. Major hepatic resection for hilar cholangiocarcinoma: analysis of 46 patients. Arch. Surg. 2004; 139 (5): 514-523; discussion 523-525. DOI: 10.1001/archsurg.139.5.514.
53.Nagino M., Kamiya J., Arai T., Nishio H., Ebata T., Nimura Y. “Anatomic” right hepatic trisectionectomy (extended right hepatectomy) with caudate lobectomy for hilar cholangiocarcinoma. Ann. Surg. 2006; 243 (1): 28-32.
54.Shimada K., Sano T., Sakamoto Y., Kosuge T. Safety and effectiveness of left hepatic trisegmentectomy for hilar cholangiocarcinoma. World J. Surg. 2005; 29 (6): 723-727. DOI: 10.1007/s00268-005-7704-5.
55.Dinant S., Gerhards M.F., Rauws E.A., Busch O.R., Gouma D.J., van Gulik T.M. Improved outcome of resection of hilar cholangiocarcinoma (Klatskin tumor). Ann. Surg. Oncol. 2006; 13 (6): 872-880. DOI: 10.1245/ASO.2006.05.053.
56.Nishio H., Nagino M., Nimura Y. Surgical management of hilar cholangiocarcinoma: the Nagoya experience. HPB (Oxford). 2005; 7 (4): 259-262. DOI: 10.1080/13651820500373010.
57.Ramesh H., Kuruvilla K., Venugopal A., Lekha V., Jacob G. Surgery for hilar cholangiocarcinoma: feasibility and results of parenchyma-conserving liver resection. Dig. Surg. 2004; 21 (2): 114-122. DOI: 10.1159/000077335.
58.Farges O., Regimbeau J.M., Fuks D., Le Treut Y.P., Cherqui D., Bachellier P., Mabrut J.Y., Adham M., Pruvot F.R., Gigot J.F. Multicentre European study of preoperative biliary drainage for hilar cholangiocarcinoma. Br. J. Surg. 2013; 100 (2): 274-283. DOI: 10.1002/bjs.8950.
59.van Gulik T.M., van den Esschert J.W., de Graaf W., van Lienden K.P., Busch O.R., Heger M., van Delden O.M., Laméris J.S., Gouma D.J. Controversies in the use of portal vein embolization. Dig. Surg. 2008; 25 (6): 436-444. DOI: 10.1159/000184735.
60.Miyazaki M., Ito H., Nakagawa K., Ambiru S., Shimizu H., Okaya T., Shinmura K., Nakajima N. Parenchyma-preserving hepatectomy in the surgical treatment of hilar cholangiocarcinoma. J. Am. Coll. Surg. 1999; 189 (6): 575-583.
61.Chen X.P., Lau W.Y., Huang Z.Y., Zhang Z.W., Chen Y.F., Zhang W.G., Qiu F.Z. Extent of liver resection for hilar cholangiocarcinoma. Br. J. Surg. 2009; 96 (10): 1167-1175. DOI: 10.1002/bjs.6618.
62.Nagino M., Ebata T., Yokoyama Y., Igami T., Sugawara G., Takahashi Y., Nimura Y. Evolution of surgical treatment for perihilar cholangiocarcinoma: a single-center 34-year review of 574 consecutive resections. Ann. Surg. 2013; 258 (1): 129-140. DOI: 10.1097/SLA.0b013e3182708b57.
63.Shimada H., Endo I., Sugita M., Masunari H., Fujii Y., Tanaka K., Sekido H., Togo S. Is parenchyma-preserving hepatectomy a noble option in the surgical treatment for highrisk patients with hilar bile duct cancer? Langenbecks Arch. Surg. 2003; 388 (1): 33-41. DOI: 10.1007/s00423-003-0358-6.
64.van Gulik T.M., Ruys A.T., Busch O.R., Rauws E.A., Gouma D.J. Extent of liver resection for hilar cholangiocarcinoma (Klatskin tumor): how much is enough? Dig. Surg. 2011; 28 (2): 141-147. DOI: 10.1159/000323825.
65.Endo I., Matsuyama R., Mori R., Taniguchi K., Kumamoto T., Takeda K., Tanaka K., Köhn A., Schenk A. Imaging and surgical planning for perihilar cholangiocarcinoma. J. Hepatobiliary Pancreat. Sci. 2014; 21 (8): 525-532. DOI: 10.1002/jhbp.75.
66.Nagino M. Perihilar cholangiocarcinoma: a surgeon''s viewpoint on current topics. J. Gastroenterol. 2012; 47 (11): 1165-1176. DOI: 10.1007/s00535-012-0628-6.
67.Kobayashi A., Miwa S., Nakata T., Miyagawa S. Disease recurrence patterns after R0 resection of hilar cholangiocarcinoma. Br. J. Surg. 2010; 97 (1): 56-64. DOI: 10.1002/bjs.6788.
68.Uesaka K. Left hepatectomy or left trisectionectomy with resection of the caudate lobe and extrahepatic bile duct for hilar cholangiocarcinoma (with video). J. Hepatobiliary Pancreat. Sci. 2012; 19 (3): 195-202. DOI: 10.1007/s00534-011-0474-6.
69.Endo I., Matsuyama R., Taniguchi K., Sugita M., Takeda K., Tanaka K., Shimada H. Right hepatectomy with resection of caudate lobe and extrahepatic bile duct for hilar cholangiocarcinoma. J. Hepatobiliary Pancreat. Sci. 2012; 19 (3): 216-224. DOI: 10.1007/s00534-011-0481-7.
70.Kondo S., Hirano S., Ambo Y., Tanaka E., Okushiba S., Morikawa T., Katoh H. Forty consecutive resections of hilar cholangiocarcinoma with no postoperative mortality and no positive ductal margins: results of a prospective study. Ann. Surg. 2004; 240 (1): 95-101.
71.Lee S.G., Lee Y.J., Park K.M., Hwang S., Min P.C. One hundred and eleven liver resections for hilar bile duct cancer. J. Hepatobiliary Pancreat. Surg. 2000; 7 (2): 135-141. DOI: 10.1007/s005340000070135.534.
72.Hemming A.W., Mekeel K., Khanna A., Baquerizo A., Kim R.D. Portal vein resection in management of hilar cholangiocarcinoma. J. Am. Coll. Surg. 2011; 212 (4): 604-613; discussion 613-616. DOI: 10.1016/j.jamcollsurg.2010.12.028.
73.Miyazaki M., Kimura F., Shimizu H., Yoshidome H., Ohtsuka M., Kato A., Yoshitomi H., Nozawa S., Furukawa K., Mitsuhashi N., Takeuchi D., Suda K., Yoshioka I. Recent advance in the treatment of hilar cholangiocarcinoma: hepatectomy with vascular resection. J. Hepatobiliary Pancreat. Surg. 2007; 14 (5): 463-468. DOI: 10.1007/s00534-006-1195-0.
74.Abbas S., Sandroussi C. Systematic review and meta-analysis of the role of vascular resection in the treatment of hilar cholangiocarcinoma. HPB (Oxford). 2013; 15 (7): 492-503. DOI: 10.1111/j.1477-2574.2012.00616.x.
75.Chen W., Ke K., Chen Y.L. Combined portal vein resection in the treatment of hilar cholangiocarcinoma: a systematic review and meta-analysis. Eur. J. Surg. Oncol. 2014; 40 (5): 489-495. DOI: 10.1016/j.ejso.2014.02.231.
76.Wu X.S., Dong P., Gu J., Li M.L., Wu W.G., Lu J.H., Mu J.S., Ding Q.C., Zhang L., Ding Q., Weng H., Liu Y.B. Combined portal vein resection for hilar cholangiocarcinoma: a metaanalysis of comparative studies. J. Gastrointest. Surg. 2013; 17 (6): 1107-1115. DOI: 10.1007/s11605-013-2202-9.
77.Neuhaus P., Jonas S., Bechstein W.O., Lohmann R., Radke C., Kling N., Wex C., Lobeck H., Hintze R. Extended resections for hilar cholangiocarcinoma. Ann. Surg. 1999; 230 (6): 808-818; discussion 819.
78.Tamoto E., Hirano S., Tsuchikawa T., Tanaka E., Miyamoto M., Matsumoto J., Kato K., Shichinohe T. Portal vein resection using the no-touch technique with a hepatectomy for hilar cholangiocarcinoma. HPB (Oxford). 2014; 16 (1): 56-61. DOI: 10.1111/hpb.12067.
79.Nagino M., Nimura Y., Nishio H., Ebata T., Igami T., Matsushita M., Nishikimi N., Kamei Y. Hepatectomy with simultaneous resection of the portal vein and hepatic artery for advanced perihilar cholangiocarcinoma: an audit of 50 consecutive cases. Ann. Surg. 2010; 252 (1): 115-123. DOI: 10.1097/SLA.0b013e3181e463a7.
80.Lau S.H., Lau W.Y. Current therapy of hilar cholangiocarcinoma. Hepatobiliary Pancreat. Dis. Int. 2012; 11 (1): 12-17.
81.Parikh A.A., Abdalla E.K., Vauthey J.N. Operative considerations in resection of hilar cholangiocarcinoma. HPB (Oxford). 2005; 7 (4): 254-258. DOI: 10.1080/13651820500373093.
82.Valls C., Ruiz S., Martinez L., Leiva D. Radiological diagnosis and staging of hilar cholangiocarcinoma. World J. Gastrointest. Oncol. 2013; 5 (7): 115-126. DOI: 10.4251/wjgo.v5.i7.115.
83.Miyazaki M., Yoshitomi H., Miyakawa S., Uesaka K., Unno M., Endo I., Ota T., Ohtsuka M., Kinoshita H., Shimada K., Shimizu H., Tabata M., Chijiiwa K., Nagino M., Hirano S., Wakai T., Wada K., Isayama H., Ok

Surgical Treatment of Hilar Cholangiocarcinoma (Review)

Kovalenko Y. A., Zharikov Y. O.

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

Новости   Магазин   Журналы   Контакты   Правила   Доставка   О компании  
ООО Издательский дом ВИДАР-М, 2016