摘要
淋巴结转移是远端胆管癌重要的预后影响因素。随着腹腔镜胰十二指肠切除术应用于远端胆管癌根治术中,探讨腹腔镜远端胆管癌根治术中淋巴清扫具有重要的临床意义。第8版美国癌症联合委员会(AJCC)癌症分期系统已于2018年1月在全世界推广应用,为远端胆管癌淋巴结清扫提供了新的推荐意见。笔者就腹腔镜远端胆管癌淋巴结清扫中区域淋巴结获取数目和阳性淋巴结数目的临床意义、淋巴结清扫中“en-block”流程、膜解剖指导下的淋巴结清扫、淋巴结清扫过程中的经验技巧、外科医师术后参与淋巴结分拣及远端胆管癌术后辅助治疗进行深入探讨。
Lymph node metastasis is the important survival predictor in patients with distal cholangiocarcinoma.With the application of laparoscopic pancreaticoduodenectomy in radical resection of distal cholangiocarcinoma,it is of great clinical significance to explore lymphadenectomy in laparoscopic radical resection of distal cholangiocarcinoma.The American Joint Committee on Cancer(AJCC)Cancer Staging Manual(8th ed)has became the new global guideline for cancer diagnosis and treatment since January 2018,which provides a new recommendation for lymphadenectomy of distal cholangiocarcinoma.This review provides an overview of the clinical significance of total lymph node count and number of involved lymph nodes,"en-block"procedure in lymphadenectomy,membrane anatomy for lymphadenectomy,experience and skills in lymph node dissection,lymph node sorting after surgery,adjuvant therapy in the treatment of distal cholangiocarcinoma.
作者
段小辉
毛先海
Duan Xiaohui;Mao Xianhai(Department of Hepatobiliary Surgery,Hunan Provincial People's Hospital,the First Affiliated Hospital of Hunan Normal University,Changsha 410005,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2019年第2期123-127,共5页
Chinese Journal of Digestive Surgery
基金
湖南省教育厅科学研究重点项目(16A127)
湖南省自然科学基金项目(2018JJ3294)
湖南省科技计划重点研发项目(2015sk2050)
湖南省人民医院仁术科研基金.
