Outcome of surgical resection in Klatskin tumors

来源 :World Journal of Gastrointestinal Oncology | 被引量 : 0次 | 上传用户:xiaobaitu11
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Cholangiocarcinomas are the second most frequent primary hepatic malignancy,and make up from 5% to 30% of malignant hepatic tumours.Hilar cholangiocarcinoma(HCC) is the most common type,and accounts for approximately 60% to 67% of all cholangiocarcinoma cases.There is not a staging system that permits us to compare all series and extract some conclusions to increase the long-survival rate in this dismal disease.Neither the extension of resection,according to the sort of HCC,is a closed topic.Some authors defend limited resection(mesohepatectomy with S1,S1 plus S4b-S5,local excision for papillary tumours,etc.) while others insist in the compulsoriness of an extended hepatic resection with portal vein bifurcation removed to reach cure.As there is not an ideal adjuvant therapy,R1 resection can be justified to prolong the survival rate.Morbidity and mortality rates changed along the last decade,but variability is the rule,with morbidity and mortality rates ranging from 14% to 76% and from 0% to 19%,respectively.Conclusion:Surgical resection continues to be the main treatment of HCC.Negative resection margins achieved with major hepatic resections are associated with improved outcome.Preresectional management with biliary drainage,portal vein embolization and staging laparoscopy should be considered in selected patients.Additional evidence is needed to fully define the role of orthotopic liver transplant.Portal and lymph node involvement worsen the prognosis and long-term survival,and surgery is the only option that can lengthen it.Improvements in adjuvant therapy are essential for improving long-term outcome.Furthermore,the lack of effective chemotherapy drugs and radiotherapy approaches leads us to can consider R1 resection as an option,because operated patients have a longer survival rate than those who not undergo surgery. Cholangiocarcinomas are the second most frequent primary hepatic malignancy, and make up from 5% to 30% of malignant hepatic tumors. Hilar cholangiocarcinoma (HCC) is the most common type, and accounts for approximately 60% to 67% of all cholangiocarcinoma cases. is not a staging system that permits us to compare all series and extract some of the results to increase the long-survival rate in this dismal disease. Neither the extension of resection, according to the sort of HCC, is a closed topic. resection (mesohepatectomy with S1, S1 plus S4b-S5, local excision for papillary tumors, etc.) while others insist in the compulsoriness of an extended hepatic resection with portal vein bifurcation removed to reach cure. As there is not an ideal adjuvant therapy, R1 resection can be justified to prolong the survival rate. Morbidity and mortality rates changed along the last decade, but variability is the rule, with morbidity and mortality rates ranging from 14% to 76% and from 0% to 19%, respectively.Conclusion: Surgical resection continues to be the main treatment of HCC. Negative resection margins achieved with major hepatic resections are associated with improved outcome. Prerectional management with biliary drainage, portal vein embolization and staging laparoscopy should be considered in selected patients. Additional evidence is needed to fully define the role of orthotopic liver transplant. Portal and lymph node involvement worsen the prognosis and long-term survival, and surgery is the only option that can lengthen it.Improvements in adjuvant therapy are essential for improving long-term outcome.Furthermore, the lack of effective chemotherapy drugs and radiotherapy approaches leads us us can can consider R1 resection as an option, because operated patients have a longer survival rate than those who not undergo surgery.
其他文献
本研究对宁夏银川市城乡结合部1所移民小学1年级儿童179人(女生86人)团体施测“儿童数感发展测验”(即前测)。根据儿童在测验各维度上的表现将其划分为:重度、中度、轻度数感
会议
本研究以处于汉字学习关键期的小学生低年级学生为研究对象,以他们的汉字学习技能与认知过程为测量目标.按照认知诊断测验研究的研究范式,首先通过认知分析(文献回顾)提出了
刘纯燕是大“金龟子”,女儿娃娃是小“金龟子”。因为家里有这样两个“活宝”,这个家庭里注定比一般家庭多一些无邪的童趣,多一些欢声笑语…… Liu Chunyan is a big “chaf
采用整群随机抽样的方法在湖南省7个县市抽取1446名小学生作为研究对象,采用文献分析法、问卷法、访谈法等理论与实证相结合的方法进行项目的收集和分析,形成项目库;对项目进行
会议
本文编制中学生科学能力测验题本,对山东、广西以及陕西省的5所八年级的中学进行施测,共3161人。共有7套题本,每套题本中有54道题,包括空间科学、生命科学、物质科学以及科学基础
会议
多项选择题是学业考试中常见的题型.其中多选一题型是多项选择题中最简单的答题方式.但作为评分者对这种多选一的答案又无法判断被试究竟存在多大程度的猜测.为了提高测量的
希德·甘尼斯1940年生于纽约,美国著名电影制片人。曾参演《总统班底》、“夺宝奇兵”系列之《印第安那·琼斯和毁灭的神庙》等经典影片。他担任制片人的代表作有喜剧片《迪
为了能够全面考察儿童的数学认知发展过程,需要将各个任务进行量尺化,以便更清楚明晰地了解儿童的发展状况。笔者了解到己有儿童发展领域相关专家根据以往研究整理出侧查儿童数
认知诊断理论的兴起使得在考试中诊断考生的认知状态成为可能。本研究以高考这种大规模考试为研究对象,运用规则空间模型,以高考数据为依据,对某省高考生在理科数学能力上的掌握
本研究在大量文献分析的基础上得出:影响题目难度的因素主要分为外部因素和内部因素两大类。通过文献分析和小范围的专家访谈,确定了高中水平数学题目的难度影响因素:内部因素