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从解剖和功能两方面来说,胆管是输送肝脏制造的胆汁至十二指肠的连续管道。传统上把胆管划分为肝内和肝外两部分。这种划分有其价值,因为肝内胆管的疾病和肝外胆管的疾病,在许多方面是有区别的。肝内胆管癌和肝外胆管癌在临床和病理方面明显不同,其理由如下:1.肝内胆管癌包涵在肝脏内,它与肝细胞癌难于区分,有时甚至用活体针刺组织检查亦无法鉴别;2.肝内胆管癌很易被误为肠胃道或胰脏癌转移至肝脏的继发癌;3.肝外胆管癌,特别是发生在近十二指肠壶腹部的,很早出现阻塞症状,接受外科切除治愈的机会较高;相反,肝内胆管癌大都是诊断过晚,无法作有效治疗,因此预后极差;4.肝外和肝内胆管癌的地区分布明显不同,肝外胆管癌,尤其
In terms of anatomy and function, the bile duct is a continuous conduit that delivers liver-made bile to the duodenum. Biliary ducts are traditionally divided into two parts: intrahepatic and extrahepatic. This division has its value, because the disease of the intrahepatic bile duct and the disease of extrahepatic bile ducts are different in many aspects. Intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma are significantly different in clinical and pathological conditions. The reasons are as follows: 1. Intrahepatic bile duct cancer is contained in the liver. It is difficult to distinguish from hepatocellular carcinoma, and sometimes even live acupuncture tissue examination can not Identification; 2. Intrahepatic bile duct cancer is easily mistaken for gastrointestinal or pancreatic cancer metastasis to the liver of secondary cancer; 3. Extrahepatic bile duct cancer, especially in the proximal duodenal ampulla, very early Obstructive symptoms are more likely to be cured by surgical resection. On the contrary, most intrahepatic cholangiocarcinomas are diagnosed too late and cannot be treated effectively. Therefore, the prognosis is extremely poor. 4. The distribution of extrahepatic and intrahepatic cholangiocarcinomas is significantly different. External bile duct cancer, especially