hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2017481-88hepato-130Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSРадикальное хирургическое лечение рака желчного пузыряCurative Surgery for Gallbladder Cancer (Review)АхаладзеД. Г.AkhaladzeD. G.

Ахаладзе Дмитрий Гурамович – канд. мед. наук, старший научный сотрудник отделения гепатопанкреатобилиарной хирургии ГБУЗ МКНЦ им. А.С. Логинова ДЗМ.

Akhaladze Dmitry Guramovich – Cand. of Med. Sci., Senior Researcher of the Hepatopancreatobiliary Surgery Department of Loginov Moscow Clinical Scientific Center of Moscow Healthcare Department.

86, Entuziastov shosse, 111123, Moscow, Russian Federation

d.akhaladze@mknc.ruАлихановР. Б.AlikhanovR. B.

Алиханов Руслан Богданович – канд. мед. наук, заведующий отделением гепатопанкреатобилиарной хирургии ГБУЗ МКНЦ им. А.С. Логинова ДЗМ.

Alikhanov Ruslan Bogdanovich – Cand. of Med. Sci., Head of the Hepatopancreatobiliary Surgery Division of Loginov Moscow Clinical Scientific Center of Moscow Healthcare Department.

ЕфановМ. Г.EfanovM. G.

Ефанов Михаил Германович – доктор мед. наук, руководитель отдела гепатопанкреатобилиарной хирургии ГБУЗ МКНЦ им. А.С. Логинова ДЗМ.

Efanov Mikhail Germanovich – Doct. of Med. Sci., Head of the Hepatopancreatobiliary Surgery Department of Loginov Moscow Clinical Scientific Center of Moscow Healthcare Department.

ГБУЗ Московский клинический научно-практический центр им. А.С. Логинова Департамента здравоохранения г. МосквыРоссияLoginov Moscow Clinical Scientific Center of Moscow Healthcare DepartmentRussian Federation2017150120182248188Copyright © Ахаладзе Д.Г., Алиханов Р.Б., Ефанов М.Г., 20182018Ахаладзе Д.Г., Алиханов Р.Б., Ефанов М.Г.Akhaladze D.G., Alikhanov R.B., Efanov M.G.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/130

Аденокарцинома желчного пузыря составляет 30–40% от всех злокачественных опухолей желчных протоков.Опухоль характеризуется агрессивным течением и низкой чувствительностью к химиотерапии, что обусловливает плохие отдаленные результаты лечения. Залогом улучшения выживаемости является достижение резекции R0. Стандартный объем хирургического лечения, включающий помимо холецистэктомии резекцию IV, V сегментов печени и лимфаденэктомию D2, является адекватным вмешательством лишь при ранних стадиях болезни. Нет единого мнения о целесообразности расширения объема операции за счет резекции внепеченочных желчных протоков, сосудов и прилежащих органов у пациентов с местнораспространенной опухолью, в том числе после предшествующих вмешательств по поводу механической желтухи и холангита. В связи с этим остаются нерешенными ряд вопросов хирургической тактики при раке желчного пузыря, освещение которых с учетом последних литературных данных представлено в настоящем обзоре.

Gallbladder adenocarcinoma is 30–40% of all malignant tumors of the bile ducts. The tumor is characterized by an aggressive course and low sensitivity to chemotherapy, that leads to poor long-term outcomes. The key of improved survival is R0-resection. Standard surgicalvolume including IV–V liver segments resection and D2-lymphadenectomybesides cholecystectomy is an adequate intervention only at the early stages of disease. There is no consensus for advisability of advanced surgery with resection of extrahepatic bile ducts, vessels and adjacent organs in patients with locally advanced tumors including those after previous interventions for mechanical jaundice and cholangitis.In view of this there are various unresolvedissues of surgical tactics for gallbladder cancer which are discussed in this review.

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