How to improve the outcome of the biliary tract carcinoma infiltrating the hepatic hilum? Investigation of intravascular ultrasography for such patients.

如何提高胆道癌浸润肝门的治疗效果？

• 批准号: 05671052
• 负责人: TSUKADA Kazuhiro
• 金额: $ 1.41万
• 依托单位: Niigata University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05671052/
• 关键词: Carcinoma of the biliary tract; Endovascular ultrasonography; Surgical treatment; Carcinoma of the gallbladder; Carcinoma of the bile duct; Carcinoma of the pancreas; Liver tumor; 肝嚢癌; 外科的切除; マイクロ探触子; 切除成績

Hepato-biliary-pancreatic carcinoma has poor prognosis and often invades the major vessels such as the portal vein and the inferior vena cava. Findings of invasion may determine indication of surgery and affect surgical procedure and it related in long-term survival. However, it is difficult to confirm the invasion accurately using ordinal ultrasonography, computed tomography, and angiography. We investigate improvement of both resectability and curability in advanced hepato-biliary-pancreatic tumor by using intravascular ultrasonohraphy. And clinical significance of the procedure was ecaluated compared with findings of operating findings, angiography, resected specimen.Thirty-six patients (5 gallbladder carcinomas, 9 bile duct carcinomas, 10 pancreatic carcinomas, 10 liver tumors and 2 other diseases) underwent endovascular ultrasonography. Intraportal procedure was performed in 31 patients and intracaval procedure was performed in 3 patients who had liver tumor. vascular invasion of the tumor was suspected in 13 patients and was confirmed in three of them by pathologic examination in the excised specimen. Resection was determined using the findings from the procedure.In conclusion endovascular ultrasonography gives accurate information of relationship between the tumor and major veins such as the portal vein and the inferior vena cava. It may be helpful to determine indication of venous resection accompanied to by radical surgery in hepato-biliary-pancreatic surgery and to prolong survival of such patients in the near future.

肝胆胰癌预后差，常侵犯门静脉、下腔静脉等主要血管。侵袭的发现可能决定手术的适应证，影响手术程序及其与长期生存的关系。然而，通过常规超声、计算机断层扫描和血管造影很难准确地确认其侵袭。我们探讨血管内超声检查对晚期肝胆胰肿瘤的可切除性和治愈率的提高。并与手术表现、血管造影、切除标本进行比较，评价手术的临床意义。36例患者行血管内超声检查，其中胆囊癌5例，胆管癌9例，胰腺癌10例，肝脏肿瘤10例，其他疾病2例。肝肿瘤31例行门静脉内手术，3例行腔内手术。13例患者怀疑肿瘤血管侵犯，其中3例经切除标本病理检查证实。根据手术结果确定切除。结论血管内超声检查能准确反映肿瘤与门静脉、下腔静脉等大静脉的关系。这可能有助于确定肝胆胰手术中静脉切除合并根治性手术的适应证，并在不久的将来延长这类患者的生存期。

项目成果

Tsukada et al: "Colligium Internnactionale Chiruigioe Digesetival Krth Coyeess" Monduzzi Editore, 569 (1994)

Tsukada 等人：“Colligium Internnactionale Chiruigioe Digesetival Krth Coyeess”Monduzzi Editore，569 (1994)

K.Tsukada et al.: "Successful treatment of a case of gallbloddn cominoma prpducing Alpha-fetoprptein with segmental adonomyomtisis" Journal of Hepato-Biliary-Pamereotic Susgey. (in press). (1996)

K.Tsukada 等人：“成功治疗一例伴有节段性子宫肌炎的胆囊腺瘤，产生α-胎蛋白蛋白”，《肝胆道帕默利奥病 Susgey 杂志》。

Tsukada K et al: "Succesful treatment of a case of gollblodden caraima producing alpha-fetopotein orth segmental atonemyometers." Journal of Hepato-Biliavy Panauctic Sugy. (in press). (1996)

Tsukada K 等人：“成功治疗了一例产生 alpha-fetopotein 或节段肌张力计的 gollblodden caraima。”

Kurosaki I,Tsukada K,et al.: "The mode of lymphatic spread incarcinoma of the bile duct." Am J Surg. (in press). (1996)

Kurosaki I，Tsukada K，et al.：“胆管癌的淋巴扩散模式。”

T.Tsubono, K.Tsukada et al.: "Hepatic Funchionel reserve in Patients with obstrudive jadce" The American Journal of Surgery. 169. 300-303 (1995)

T.Tsubono、K.Tsukada 等人：“阻塞性肌无力患者的肝功能储备”，《美国外科杂志》。