肝門部胆管癌の総括

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  • Hilar cholangiocarcinoma-overview

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Local anatomy of the hepatic hilus and surgical anatomy of the hepatic segments and subsegments have been studied by Western surgeons, however clinical and surgical anatomy was further studied by Japanese clinician.<BR>Recent development of MDCT changed a diagnostic work-up system and provides much useful information about the stage of the disease and suggested surgical procedures. However, there have been several unresolved questions: endoscopic or percutaneous biliary drainage? timing of cholestatic liver resection after portal vein embolization? which should be clarified in the near future. Indication of surgical resection has not been standardized and each institution has its own criteria which should be standardized and established in the near future as surgical resection is the only treatment of choice to cure the patients. Therefore indication of nonsurgical treatment should be reevaluated after careful investigation of the stage of the disease not to lose a change of cure.<BR>Further clinical studies are required to establish adjuvant treatments to provide high level of evidences.

収録刊行物

  • Tando

    Tando 21 (5), 702-708, 2007

    Japan Biliary Association

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