摘要
胆管下段癌早期诊断困难,中晚期须结合腹部超声、CT、磁共振、MRCP、ERCP和超声内镜等进行诊断.胆管下段癌的切除率为50%-75%.根治性手术,采用胰十二指肠切除术,多数主张采用保留幽门的胰十二指肠切除术或胃次全保留的胰十二指肠切除术,并进行肝十二指肠韧及肠系膜上动脉周围的淋巴结廓清.根据病例情况,可以进行门静脉合并切除,血管重建.不能切除病例,采用各种减黄方法及综合治疗.
Early-stage （pre-icterus stage） distal bile duct cancer is difficult to be diagnosed, and middle- or advanced-stage distal bile duct cancer may be diagnosed using abdomenal ultrasound, CT, MRI, MRCP, ERCP, EUS and so on. About 50% to 70% distal bile duct cancer can be successfully resected. For radical surgery, pancreatoduodenectomy, especially pylorus-preserving or subtotal stomach-preserving pancreatoduodenectomy is mostly used; meanwhile, liver duodenum ligament and lvmph nodes around the mesentery artery were cleaned up. Portal vein excision and blood vessel reconstruction may be performed according to the case situation. For the case that can not be removed, comprehensive therapy together with jaundice-reducing method should be selected.
出处
《世界华人消化杂志》
CAS
北大核心
2008年第30期3363-3366,共4页
World Chinese Journal of Digestology
关键词
胆管下段癌
胆管癌
诊断
治疗
Distal bile duct cancer
Bile duct cancer
Diagnosis
Treatment
作者简介
王凤山，1996年获医学博士，教授，从事肝胆外科及器官移植的基础研究和临床工作.通讯作者：王凤山，110001，辽亍省沈陪市和平区南京北街155号，中国医科大学附属第一医院普通外科教研室肝胆外科wangfs2006@yahoo．com．cn电话：024-83283308
