Background: For recurrent cholangiocarcinoma, systemic chemotherapy is the standard of care. Repeated resection is a potential curative treatment, but data are scarce and outcomes are not well defined so far. Summary: In the last decade there has been an increasing number of reports suggesting a survival benefit and even cure after repeated surgery. This is particularly true for intrahepatic cholangiocarcinoma, where repeated resections offer similar or even better results than the first resection. In selected cases even a third liver resection is possible. In contrast, in perihilar and distal cholangiocarcinoma, repeated resection is only rarely possible. Although the improved outcome might be attributed to a careful patient selection and a favorable tumor biology, repeated surgical treatment should be attempted whenever possible. This necessitates a structured follow-up after resection. Key Message: Surgical resection offers the chance for prolonged survival and even for cure in recurrent cholangiocarcinoma. Hence, it is of the utmost importance to better understand the routes of metastases and to define factors qualifying for resection. Whether different patterns of recurrence reflect biological heterogeneity requires further investigation.
Visc Med

中文翻译：

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复发性胆管癌的手术方法

背景：对于复发性胆管癌，全身化疗是标准治疗。重复切除是一种潜在的治愈性治疗方法，但数据稀少，结果尚不明确。概括：在过去的十年中，越来越多的报告表明重复手术后的生存益处甚至治愈。这对于肝内胆管癌尤其如此，其中重复切除提供与第一次切除相似甚至更好的结果。在某些情况下，甚至可以进行第三次肝切除术。相比之下，在肺门周围和远端胆管癌中，重复切除很少可能。虽然改善的结果可能归因于仔细的患者选择和有利的肿瘤生物学，但应尽可能尝试重复手术治疗。这需要在切除后进行结构化的随访。关键信息：手术切除为延长生存期甚至治愈复发性胆管癌提供了机会。因此，最重要的是更好地了解转移的路径并确定符合切除条件的因素。不同的复发模式是否反映了生物异质性需要进一步研究。
粘性医学