肝细胞癌合并胆管癌栓的肝移植治疗（附3例报道）_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 刘鹏 , 袁伟升 , 宫琳 , 陆小亮 , 王鹏

中国人民解放军第401医院肝胆外科·济南军区肝移植中心（山东青岛 266071）;

Corresponding author：

刘鹏, Email: liupeng401gd@163.com

Keywords：

肝细胞癌; 胆管癌栓; 肝移

DOI：

10.7507/1007-9424.20160090

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的总结肝移植治疗肝细胞癌合并胆管癌栓的临床经验。方法回顾性分析2003年10月至2012年12月期间于笔者所在医院接受肝移植治疗的3例肝细胞癌合并胆管癌栓患者的临床资料，总结临床经验。结果3例肝细胞癌合并胆管癌栓患者均行改良背驮式原位肝移植术。术后免疫抑制剂方案均采用他克莫司+吗替麦考酚酯+甲泼尼龙。术后2例行全身化疗。2例口服拉米夫定抗病毒治疗，1例口服恩替卡韦抗病毒治疗。3例患者均联合应用乙型肝炎免疫球蛋白预防乙肝复发。术后2例分别无瘤生存141个月和38个月，1例于术后3年死于肿瘤复发。结论对于肝细胞癌合并胆管癌栓患者，选择适当病例施行肝移植手术，可能是一种积极有效的治疗措施。

Citation： 刘鹏, 袁伟升, 宫琳, 陆小亮, 王鹏. 肝细胞癌合并胆管癌栓的肝移植治疗（附3例报道）. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(3): 343-344. doi: 10.7507/1007-9424.20160090 Copy

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2.	Peng SY, Wang JW, Liu YB, et al. Surgical intervention for obstruc-tive jaundice due to biliary tumor thrombus in hepatocellular carcinoma. World J Surg, 2004, 28(1): 43-46.
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5.	Moon DB, Hwang S, Wang HJ, et al. Surgical outcomes of hepatoce-llular carcinoma with bile duct tumor thrombus: a Korean multi-center study. World J Surg, 2013, 37(2): 443-451.
6.	Wong TC, Cheung TT, Chok KS, et al. Outcomes of hepatectomy for hepatocellular carcinoma with bile duct tumour thrombus. HPB (Oxford), 2015, 17(5): 401-408.
7.	Ha TY, Hwang S, Moon DB, et al. Long-term survival analysis of liver transplantation for hepatocellular carcinoma with bile duct tumor thrombus. Transplant Proc, 2014, 46(3): 774-777.
8.	刘超. 重视肝细胞癌合并胆管癌栓的诊断与治疗. 中华肝脏外科手术学电子杂志, 2014, 3(3): 139-141.
9.	Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11): 693-699.
10.	王坤, 朱冰, 杨尚九, 等. 肝细胞癌合并胆管癌栓诊断及治疗进展. 中国老年学杂志, 2013, 33(9): 2222-2225.
11.	彭淑牖, 王建伟, 刘颖斌, 等. 原发性肝癌伴胆管癌栓的外科治疗. 中华外科杂志, 2003, 41(3): 169-171.
12.	谭蔚锋, 罗祥基, 张柏和, 等. 原发性肝癌合并胆管癌栓不同疗法的效果比较. 中国普通外科杂志, 2008, 17(10): 1033-1036.
13.	Lee KW, Park JW, Park JB, et al. Liver transplantation for hepatoce-llular carcinoma with bile duct thrombi. Transplant Proc, 2006, 38(7): 2093-2094.
14.	Liu C, Wang J. Long-term survival after liver transplant for recurrent hepatocellular carcinoma with bile duct tumor thrombus: case report. Exp Clin Transplant, 2012, 10(6): 614-617.
15.	Kim JM, Kwon CH, Joh JW, et al. The effect of hepatocellular carcinoma bile duct tumor thrombi in liver transplantation. Hepatogastroenterology, 2014, 61(134): 1673-1676.

1. Rammohan A, Sathyanesan J, Rajendran K, et al. Bile duct thrombi in hepatocellular carcinoma: is aggressive surgery worthwhile?. HPB (Oxford), 2015, 17(6): 508-513.
2. Peng SY, Wang JW, Liu YB, et al. Surgical intervention for obstruc-tive jaundice due to biliary tumor thrombus in hepatocellular carcinoma. World J Surg, 2004, 28(1): 43-46.
3. Ueda M, Takeuchi T, Takayasu T, et al. Classification and surgical treatment of hepatocellular carcinoma (HCC) with bile duct thrombi. Hepatogastroenterology, 1994, 41(4): 349-354.
4. Satoh S, Ikai I, Honda G, et al. Clinicopathologic evaluation of hepatocellular carcinoma with bile duct thrombi. Surgery, 2000, 128(5): 779-783.
5. Moon DB, Hwang S, Wang HJ, et al. Surgical outcomes of hepatoce-llular carcinoma with bile duct tumor thrombus: a Korean multi-center study. World J Surg, 2013, 37(2): 443-451.
6. Wong TC, Cheung TT, Chok KS, et al. Outcomes of hepatectomy for hepatocellular carcinoma with bile duct tumour thrombus. HPB (Oxford), 2015, 17(5): 401-408.
7. Ha TY, Hwang S, Moon DB, et al. Long-term survival analysis of liver transplantation for hepatocellular carcinoma with bile duct tumor thrombus. Transplant Proc, 2014, 46(3): 774-777.
8. 刘超. 重视肝细胞癌合并胆管癌栓的诊断与治疗. 中华肝脏外科手术学电子杂志, 2014, 3(3): 139-141.
9. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11): 693-699.
10. 王坤, 朱冰, 杨尚九, 等. 肝细胞癌合并胆管癌栓诊断及治疗进展. 中国老年学杂志, 2013, 33(9): 2222-2225.
11. 彭淑牖, 王建伟, 刘颖斌, 等. 原发性肝癌伴胆管癌栓的外科治疗. 中华外科杂志, 2003, 41(3): 169-171.
12. 谭蔚锋, 罗祥基, 张柏和, 等. 原发性肝癌合并胆管癌栓不同疗法的效果比较. 中国普通外科杂志, 2008, 17(10): 1033-1036.
13. Lee KW, Park JW, Park JB, et al. Liver transplantation for hepatoce-llular carcinoma with bile duct thrombi. Transplant Proc, 2006, 38(7): 2093-2094.
14. Liu C, Wang J. Long-term survival after liver transplant for recurrent hepatocellular carcinoma with bile duct tumor thrombus: case report. Exp Clin Transplant, 2012, 10(6): 614-617.
15. Kim JM, Kwon CH, Joh JW, et al. The effect of hepatocellular carcinoma bile duct tumor thrombi in liver transplantation. Hepatogastroenterology, 2014, 61(134): 1673-1676.

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肝细胞癌合并胆管癌栓的肝移植治疗（附3例报道）

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