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肝外胆道肿瘤是一种恶性程度较高、预后较差的肿瘤,手术治疗是其唯一有治愈可能的治疗方法。根治性手术切除时常需联合血管或肝尾状叶切除及行区域淋巴结清扫,姑息切除加术后辅助治疗也可延长患者的生存时间并提高生活质量。对重度黄疸或预计术后肝残余量不足患者,术前行健侧胆道引流或病肝侧门静脉栓塞术,可减少术后并发症。对不能手术切除或伴有转移的进展期胆管癌,化疗、放疗、分子靶向药物、介入等治疗具有一定改善整体生存和生活质量的作用,并可能获得二次手术机会。
Extrahepatic biliary tract cancer is a malignant tumor with poor prognosis. Surgical treatment is the only cure for it. Radical surgical resection often associated with vascular or caudate lobe resection and regional lymph node dissection, palliative resection and postoperative adjuvant therapy can also extend the patient’s survival time and improve quality of life. For patients with severe jaundice or who are expected to have insufficient postoperative residual liver mass, preoperative biliary drainage or diseased biliary drainage may reduce postoperative complications. The treatment of advanced cholangiocarcinoma, chemotherapy, radiotherapy, molecular targeted drugs and interventional therapy which can not be surgically removed or accompanied with metastasis has the certain effect of improving overall survival and quality of life, and may obtain the chance of secondary surgery.