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肝门部胆管癌在胆管癌中最常见、也最难处理。近10多年来肝门胆管癌的外科治疗手段,尤其在手术切除这一高难度技术方面取得了突破性进展,已有大量远期疗效的报告证明:肝门胆管癌唯一可达到根治目的的治疗方法是手术切除或联合肝叶的扩大根治术。然而,术后5年生存率在较大组(500例以上)的报告中仅为10%,中位生存时间为23个月,与近些年手术切除率的增加势头不相符合。临床上实际无法根治性切除的中晚期患者仍占半数以上,且肝门部肿瘤的特征较为复杂,临床分类还不够完善,因此对治疗方式的选择仍处在发展与探索阶段。
The hilar cholangiocarcinoma is the most common and difficult to treat in cholangiocarcinoma. The surgical treatment of hilar cholangiocarcinoma in the past 10 years, especially in the difficult technique of surgical resection, has made a breakthrough, a large number of reports of long-term efficacy have proved: the only treatment for hilar cholangiocarcinoma can achieve the purpose of radical cure The method is surgical resection or combined radical hepatectomy. However, the postoperative 5-year survival rate was only 10% in the report of the larger group (more than 500 cases), and the median survival time was 23 months, which was inconsistent with the increase in surgical resection rate in recent years. Clinically, mid-advanced patients who cannot undergo radical resection still account for more than half of the patients. The features of hilar tumors are complex and the clinical classification is still not perfect. Therefore, the choice of treatment methods is still in the development and exploration stage.