肝内胆管细胞癌多学科诊疗策略及发展现状
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湖南省人民医院/湖南师范大学第一附属医院 肝胆外科,湖南 长沙 410005

作者简介:

刘苏来,湖南省人民医院/湖南师范大学第一附属医院副主任医师,主要从事肝内外胆管结石、肝癌、胆管癌、胰腺癌诊断及手术治疗,肝胆胰恶性肿瘤综合治疗方面的研究。

基金项目:

湖南省自然科学基金优秀青年项目(2021JJ20003);湖南省卫生健康委员会2019年中央财政补助国家和省级临床重点专科能力建设基金资助项目[湘卫医政医管处便函(2019)118]。


Current status and strategies of multidisciplinary diagnosis and treatment of intrahepatic cholangiocarcinoma
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Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital/the First Affiliated Hospital of Hunan Normal University, Changsha 410005, China

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    摘要:

    肝内胆管细胞癌(ICC)起源于二级及以上胆管上皮细胞,是一种具有高度侵袭性的恶性肿瘤,其早期常无特异性的临床表现,诊断时常处于晚期,失去根治性手术切除的机会。随着ICC多学科诊疗模式的提出和广泛应用,其疾病控制效果和患者的生存期得到了提升,但是其预后仍差。在目前以外科手术为核心的多学科诊疗模式中,应该关注患者的中长期获益,并将其作为最终目标贯穿治疗全过程。鉴于ICC治疗选择的多样性及疾病复杂性,任何治疗策略均建议通过多学科讨论得出个体化的诊疗方案,并建议在高度专业化的肝胆胰中心进行诊疗或者由其指导进行诊疗。此文中,笔者重点阐述ICC的多学科诊疗的发展现状及策略。

    Abstract:

    Intrahepatic cholangiocarcinoma (ICC) is a highly aggressive malignant tumor arising from the epithelial cells of the second-order or more proximal bile ducts. ICC usually has no early warning signs, so most patients are diagnosed at an advanced stage and have no chance of radical surgery. With the introduction and widespread implementation of multidisciplinary diagnosis and treatment model for ICC, the disease control effect and survival time of patients have been improved, but the prognosis is still unfavorable. In the current surgery-based multidisciplinary diagnosis and treatment approach, attention should be focused on the mid- and long-term benefits to patients, and take this as the end goal throughout the whole process of treatment. Given the diversity of treatment options and the complexity of the disease, all treatment strategies recommend creating individualized management plans based on multidisciplinary discussion, and that the diagnosis and treatment should be conducted at or directed by a highly specialized hepatobiliary and pancreatic center. Here, the authors emphatically describe the development status and strategies of multidisciplinary diagnosis and treatment of ICC.

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刘苏来,刘培,宋颖辉,余张涛,彭创.肝内胆管细胞癌多学科诊疗策略及发展现状[J].中国普通外科杂志,2023,32(2):269-278.
DOI:10.7659/j. issn.1005-6947.2023.02.013

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  • 收稿日期:2022-09-25
  • 最后修改日期:2023-01-25
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  • 在线发布日期: 2023-03-02