原位在体冷灌注技术下复杂肝门部胆管癌根治性切除_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

邢洪铭 ^1,2 , 游欣雨 ^1,3 , 黄建花 ^1,3 , 庞北川 ^1,2 ,  张宇 ^1,2

1. ;
2. ;
3. ;

Corresponding author：

张宇, Email: zhangyuqg@med.uestc.edu.cn

Keywords：

肝门部胆管癌; 在体灌注技术; 血管重建

DOI：

10.7507/1007-9424.202404119

Video：

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目的探究在体灌注技术在治疗侵犯门静脉超过P 点的Bismuth-Corlette Ⅳ 型肝门部胆管癌(hilar cholangiocarcinoma，HCCA)中的可行性。方法报道1例通过在体灌注技术实现对侵犯门静脉超过P 点的Bismuth-Corlette Ⅳ 型HCCA的根治性切除。结果肿瘤实现了根治性切除，受侵脉管成功重建，患者术后病理报告为高分化HCCA。术后恢复良好，无并发症。随访12个月未见复发。结论原位在体灌注技术可作为复杂HCCA的一种可行的治疗方案。但手术难度大、病例选择性极高，需要术前充分评估。

Citation： 邢洪铭, 游欣雨, 黄建花, 庞北川, 张宇. 原位在体冷灌注技术下复杂肝门部胆管癌根治性切除. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(12): 1512-1514. doi: 10.7507/1007-9424.202404119 Copy

1.	Benson AB, D’Angelica MI, Abrams T, et al. NCCN Guidelines^® Insights: Biliary Tract Cancers, Version 2. 2023. J Natl Compr Canc Netw, 2023, 21(7): 694-704.
2.	中华医学会外科学分会胆道外科学组, 中国医师协会外科医师分会胆道外科专家工作组. 胆道恶性肿瘤全程规范化管理中国专家共识(2023). 中华外科杂志, 2024, 62(6): 504-513.
3.	中华医学会外科学分会胆道外科学组, 解放军全军肝胆外科专业委员会. 肝门部胆管癌诊断和治疗指南(2013版). 中华外科杂志, 2013, 51(10): 865-871.
4.	Gyoten K, Kuriyama N, Maeda K, et al. Safety and efficacy of neoadjuvant chemotherapy based on our resectability criteria for locally advanced perihilar cholangiocarcinoma. Langenbecks Arch Surg, 2023, 408(1): 261. doi:10.1007/s00423-023-03000-5.
5.	Kuriyama N, Usui M, Gyoten K, et al. Neoadjuvant chemotherapy followed by curative-intent surgery for perihilar cholangiocarcinoma based on its anatomical resectability classification and lymph node status. BMC Cancer. 2020, 20(1): 405. doi:10.1186/s12885-020-06895-1.
6.	Cillo U, Fondevila C, Donadon M, et al. Surgery for cholangiocarcinoma. Liver Int, 2019, 39 Suppl 1(Suppl Suppl 1): 143-155.
7.	Rea DJ, Heimbach JK, Rosen CB, et al. Liver transplantation with neoadjuvant chemoradiation is more effective than resection for hilar cholangiocarcinoma. Ann Surg, 2005, 242(3): 451-461.
8.	Chui AK, Island ER, Rao AR, et al. The longest survivor and first potential cure of an advanced cholangiocarcinoma by ex vivo resection and autotransplantation: a case report and review of the literature. Am Surg, 2003, 69(5): 441-444.
9.	黄洁夫, 刘唐彬, 李桂生, 等. 改进的肝脏原位低温灌注下无血切肝术. 普通外科杂志, 1992, 1(4): 196-199.
10.	Kato A, Singh S, McLeish KR, et al. Mechanisms of hypothermic protection against ischemic liver injury in mice. Am J Physiol Gastrointest Liver Physiol, 2002, 282(4): G608-G616. doi: 10.1152/ajpgi.00454.2001.
11.	Azoulay D, Eshkenazy R, Andreani P, et al. In situ hypothermic perfusion of the liver versus standard total vascular exclusion for complex liver resection. Ann Surg, 2005, 241(2): 277-285.
12.	Kumada K, Yamaoka Y, Morimoto T, et al. Partial autotransplantation of the liver in hepatocellular carcinoma complicating cirrhosis. Br J Surg, 1992, 79(6): 566-567.
13.	Del Campo C. Concomitant major hepatectomy and inferior vena cava reconstruction. J Am Coll Surg, 1999, 189(3): 338-339.
14.	Hoti E, Salloum C, Azoulay D. Hepatic resection with in situ hypothermic perfusion is superior to other resection techniques. Dig Surg, 2011, 28(2): 94-99.

1. Benson AB, D’Angelica MI, Abrams T, et al. NCCN Guidelines^® Insights: Biliary Tract Cancers, Version 2. 2023. J Natl Compr Canc Netw, 2023, 21(7): 694-704.
2. 中华医学会外科学分会胆道外科学组, 中国医师协会外科医师分会胆道外科专家工作组. 胆道恶性肿瘤全程规范化管理中国专家共识(2023). 中华外科杂志, 2024, 62(6): 504-513.
3. 中华医学会外科学分会胆道外科学组, 解放军全军肝胆外科专业委员会. 肝门部胆管癌诊断和治疗指南(2013版). 中华外科杂志, 2013, 51(10): 865-871.
4. Gyoten K, Kuriyama N, Maeda K, et al. Safety and efficacy of neoadjuvant chemotherapy based on our resectability criteria for locally advanced perihilar cholangiocarcinoma. Langenbecks Arch Surg, 2023, 408(1): 261. doi:10.1007/s00423-023-03000-5.
5. Kuriyama N, Usui M, Gyoten K, et al. Neoadjuvant chemotherapy followed by curative-intent surgery for perihilar cholangiocarcinoma based on its anatomical resectability classification and lymph node status. BMC Cancer. 2020, 20(1): 405. doi:10.1186/s12885-020-06895-1.
6. Cillo U, Fondevila C, Donadon M, et al. Surgery for cholangiocarcinoma. Liver Int, 2019, 39 Suppl 1(Suppl Suppl 1): 143-155.
7. Rea DJ, Heimbach JK, Rosen CB, et al. Liver transplantation with neoadjuvant chemoradiation is more effective than resection for hilar cholangiocarcinoma. Ann Surg, 2005, 242(3): 451-461.
8. Chui AK, Island ER, Rao AR, et al. The longest survivor and first potential cure of an advanced cholangiocarcinoma by ex vivo resection and autotransplantation: a case report and review of the literature. Am Surg, 2003, 69(5): 441-444.
9. 黄洁夫, 刘唐彬, 李桂生, 等. 改进的肝脏原位低温灌注下无血切肝术. 普通外科杂志, 1992, 1(4): 196-199.
10. Kato A, Singh S, McLeish KR, et al. Mechanisms of hypothermic protection against ischemic liver injury in mice. Am J Physiol Gastrointest Liver Physiol, 2002, 282(4): G608-G616. doi: 10.1152/ajpgi.00454.2001.
11. Azoulay D, Eshkenazy R, Andreani P, et al. In situ hypothermic perfusion of the liver versus standard total vascular exclusion for complex liver resection. Ann Surg, 2005, 241(2): 277-285.
12. Kumada K, Yamaoka Y, Morimoto T, et al. Partial autotransplantation of the liver in hepatocellular carcinoma complicating cirrhosis. Br J Surg, 1992, 79(6): 566-567.
13. Del Campo C. Concomitant major hepatectomy and inferior vena cava reconstruction. J Am Coll Surg, 1999, 189(3): 338-339.
14. Hoti E, Salloum C, Azoulay D. Hepatic resection with in situ hypothermic perfusion is superior to other resection techniques. Dig Surg, 2011, 28(2): 94-99.

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原位在体冷灌注技术下复杂肝门部胆管癌根治性切除

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