Application of perihilar surgical techniques in intrahepatic cholangiocarcinoma invading hepatic hilum / 中国实用外科杂志

ABSTRACT

Intrahepatic cholangiocarcinoma invading hepatic hilum has the biological characteristics and clinical features of both gallbladder cancer and hilar cholangiocarcinoma, and it also combines the pathophysiological changes of liver disease.There are a series of therapeutic difficulties such as difficult exposure of three hepatic hilum, complexity of liver resection,difficult treatment of combined liver diseases and insensitivity to radiotherapy and chemotherapy, which result in low radical resection rate, difficulty in operation, high operative risk and poor prognosis. The perihilar surgical technique system based on special clinical features, surgical methods and pathophysiological characteristics, evaluates the tumor resectability, the anatomy structure of three hepatic hilum and the reserved liver function comprehensively and accurately before surgery, completely exposes hepatic hilum via combining anterograde and retrograde route from extra and intra-hepatic direction to hepatic hilum, combined with accurate liver resection, accurate and high-quality biliary anastomosis and management of postoperative complication,which can improve surgical radicalization and safety, reduce surgical risk and postoperative complication rate, thereby improve the overall survival time of patients.