晚期肝门部胆管癌伴门静脉狭窄门静脉支架置入术的治疗现状

Current Status of Portal Vein Stenting in the Treatment of Advanced Hilar Cholangiocarcinoma with Portal Vein Stenosis

摘要: 肝门部胆管癌的发病率逐年上升，由于起病隐匿导致疾病发现晚，即使有手术机会，但因手术难度大、根治率低、术后易出现并发症等因素，5年生存率不足30%。晚期或复发的肝门胆管癌常伴门静脉狭窄或闭塞。门静脉主干或第一级分支狭窄/闭塞，可造成肝功能损伤、腹水、食管胃底静脉曲张出血、血小板减少等并发症。这些并发症不仅会导致患者生活质量低下，甚至会危及患者生命。对肝门胆管癌患者的影响更为重要，可导致患者预后不良，生存时间大幅缩短。因此，解除门静脉狭窄是治疗此类问题的关键。本文就介入治疗晚期肝门胆管癌伴门静脉狭窄的临床疗效作一综述，并进一步展望介入治疗在后期患者抗癌治疗、提高患者生存质量等方面的临床应用价值。

Abstract: The incidence of hilar cholangiocarcinoma is increasing year by year. Late detection of hilar cholan-giocarcinoma is due to hidden onset. Even if there is an opportunity for surgery, the 5-year survival rate is less than 30% due to the difficulty of surgery, low radical treatment rate and postoperative complications. Advanced or recurrent hilar cholangiocarcinoma is often accompanied by portal vein stenosis or occlusion. The main portal vein or the first branch stenosis/occlusion, can lead to liver injury, ascites, esophageal and gastric varices bleeding, thrombocytopenia and other complications. These complications will not only lead to poor quality of life of patients, but even endanger patients’ lives. The effect on hilar cholangiocarcinoma patients is more important, which can lead to poor prognosis and greatly shorten survival time. Therefore, the removal of portal vein stenosis is the key to the treatment of such problems. This article reviews the clinical efficacy of interventional therapy for advanced hilar cholangiocarcinoma with portal vein stenosis, and further looks forward to the clinical application value of interventional therapy in anticancer treatment and improving the quality of life of patients in the later stage.