臨床外科69巻8号

2014年08月発行

特集 肝胆膵癌の血管浸潤をどう治療するか

肝門部胆管癌の門脈・肝動脈浸潤

著者： 伊神剛¹ 江畑智希¹ 横山幸浩¹ 菅原元¹ 水野隆史¹ 山口淳平¹ 國料俊男¹ 角田伸行¹ 深谷昌秀¹ 上原圭介¹ 板津慶太¹ 梛野正人¹

所属機関： ¹名古屋大学大学院医学系研究科腫瘍外科

ページ範囲：P.938 - P.946

【ポイント】

◆肝門部胆管癌の診断では，胆道ドレナージを施行する前にMDCTを撮影する．

◆血管浸潤の診断では，MDCTのMPR画像をlow density planeの有無を中心に詳細に読影し，安易に非切除と診断しない．

◆肝門部胆管癌に対する血管合併切除は，門脈，肝動脈にかかわらず十分に意義のある術式であるが，過大侵襲でリスクを伴う術式であり，手術を施行する場合には，周術期管理に手馴れたスタッフの多いhigh volume centerで施行するべきである．

参考文献

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