hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2017472-80hepato-129Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSКонцептуальные аспекты хирургического лечения воротной холангиокарциномыSurgical Treatment of Hilar Cholangiocarcinoma (Review)КоваленкоЮ. А.KovalenkoYu. A.

Коваленко Юрий Алексеевич – канд. мед. наук, старший научный сотрудник отдела абдоминальной хирургии, отделения хирургической гепатологии и панкреатологии ФГБУ “Институт хирургии им. А.В. Вишневского” Минздрава России.

Kovalenko Yury Alexeevich – Cand. of Med. Sci., Senior Researcher of Abdominal Surgery Division, Department of Liver and Pancreatic Surgery of A.V. Vishnevsky Institute of Surgery.

ЖариковЮ. О.ZharikovYu. O.

Жариков Юрий Олегович – канд. мед. наук, врач-хирург отдела абдоминальной хирургии, отделения хирургической гепатологии и панкреатологии ФГБУ “Институт хирургии им. А.В. Вишневского” Минздрава России.

117997, г. Москва, ул. Большая Серпуховская, д. 27, Российская Федерация

Zharikov Yury Olegovich – Cand. of Med. Sci., Surgeon of Abdominal Surgery Division, Department of Liver and Pancreatic Surgery, A.V. Vishnevsky Institute of Surgery.

27, str. Bolshaya Serpukhovskaya, Moscow, 117997, Russian Federation

dr_zharikov@mail.ruФГБУ “Институт хирургии им. А.В. Вишневского” Министерства здравоохранения Российской ФедерацииРоссияA.V. Vishnevsky Institute of SurgeryRussian Federation2017150120182247280Copyright © Коваленко Ю.А., Жариков Ю.О., 20182018Коваленко Ю.А., Жариков Ю.О.Kovalenko Y.A., Zharikov Y.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/129

Целью данной статьи является отражение современных подходов к хирургическому лечению воротной холангиокарциномы. Радикальная операция (R0-резекция) должна быть основной целью лечения. В настоящее время резекция I сегмента и части IV сегмента печени в сочетании с правосторонней или левосторонней гемигепатэктомией, резекцией внепеченочных желчных протоков, лимфодиссекция гепатодуоденальной связки и в некоторых случаях сосудистая резекция являются стандартом хирургического лечения опухоли Клацкина.В последнее время малая резекция печени как операция выбора была предложена для лечения этого заболевания. Однако безопасность и эффективность такого подхода являются спорными. Кроме того, на сегодняшний день нет консенсуса в отношении резектабельности опухоли у пациентов с местнораспространенной воротной холангиокарциномой.

The aim of this article is to describe the modern surgical approaches for hilar cholangiocarcinoma management.R0-resection should be the main goal of treatment. At present time resection of the caudate lobe and the part of segment IV combined with right- or left-sided hepatectomy, bile duct resection, lymphadenectomy of the hepatic hilum and sometimes vascular resection is the standard surgical procedure for Klatskin tumors. More recently minor liver resections have been proposed for treatment of this tumor. However, the safety and effectiveness of this approach are controversial. Moreover, there is no consensus for patients with locally advanced hilar cholangiocarcinoma.

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The authors declare that there are no conflicts of interest present.