臨床外科68巻1号

2013年01月発行

特集 進歩する消化器外科手術―術式の温故知新 〔疾患別〕

肝門部胆管癌手術の温故知新

著者： 清水宏明¹ 吉留博之¹ 大塚將之¹ 加藤厚¹ 吉富秀幸¹ 古川勝規¹ 竹内男¹ 高屋敷吏¹ 久保木知¹ 鈴木大亮¹ 中島正之¹ 宮崎勝¹

所属機関： ¹千葉大学大学院医学研究院臓器制御外科学

ページ範囲：P.38 - P.42

【ポイント】

◆肝門部胆管癌に対しては治癒切除が唯一の根治性が得られる治療法であるため，これまで，安全な，かつ根治が得られるstrategyが積極的に追求されてきた．

◆肝門部の緻密な外科解剖の研究をはじめ，尾状葉切除の必要性，術前門脈塞栓術，さらには，肝門部血管合併切除は，わが国から世界に向けて発信された誇るべき業績であり，肝門部胆管癌の外科切除の安全性，根治性を向上させるうえで大きな意味をもった．

◆現在では拡大肝葉切除と尾状葉切除が肝門部胆管癌の外科切除のスタンダードになっているが，適切な術前処置と術後のきめ細かい周術期管理が手術を成功に導く重要なポイントと考える．

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