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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">clinicaloncology</journal-id><journal-title-group><journal-title xml:lang="ru">Клинический случай в онкологии</journal-title><trans-title-group xml:lang="en"><trans-title>Clinical Case in Oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3034-1477</issn><issn pub-type="epub">3034-4018</issn><publisher><publisher-name>ОНКОПРАКТИК</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.62546/30341477-2025-3-4-43-52</article-id><article-id custom-type="elpub" pub-id-type="custom">clinicaloncology-148</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ СЛУЧАИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CASE REPORTS</subject></subj-group></article-categories><title-group><article-title>Холангиоцеллюлярный рак дистального отдела холедоха. Клиническое наблюдение с выполнением резекции холедоха и гепатикуса, формированием гепатикоеюноанастомоза на петле тонкой кишки по Ру</article-title><trans-title-group xml:lang="en"><trans-title>Cancer of the distal part of the choledochus. Clinical observation with resection of the choledochus and hepatic duct, and formation of a hepatico-jejunal anastomosis on a Roux loop. Roux-en-Y hepaticojejunostomy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1391-0516</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Будурова</surname><given-names>М. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Budurova</surname><given-names>Marina D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Будурова Марина Дмитриевна,</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">m.budurova@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1879-6978</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Трифанов</surname><given-names>В. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Trifanov</surname><given-names>Vladimir S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Трифанов Владимир Сергеевич,</p><p>Москва.</p><p>Конфликт интересов: Трифанов В.С. является членом редакционной коллегии данного журнала и не участвовал в редакционном рецензировании или решении о публикации этой статьи. Статья прошла принятую в журнале процедуру рецензирования. Об иных конфликтах интересов авторы не заявляли.</p></bio><bio xml:lang="en"><p>Moscow.</p><p>Conflict of interests: Vladimir S. Trifanovis an Editorial Board Member for this journal and was not involved in the editorial review or the decision to publish this article. The article underwent the journal’s peer-review process.</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1021-4382</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мирзаев</surname><given-names>Т. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Mirzaev</surname><given-names>Turon S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мирзаев Турон Савронович,</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-6706-4185</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иконова</surname><given-names>К. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Iconova</surname><given-names>Ksenia A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Иконова Ксения Анатольевна,</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Московский научно-исследовательский онкологический институт им. П. А. Герцена, Национальный медицинский исследовательский центр радиологии; Московский государственный медико-стоматологический университет им. А. И. Евдокимова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>P. A. Herzen Moscow Research Oncological Institute National Medical Research Center of Radiology; Moscow State Medical and Dental University named after A. I. Evdokimov, Department of Oncology FDPO</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Московский научно-исследовательский онкологический институт им. П. А. Герцена, Национальный медицинский исследовательский центр радиологии</institution><country>Россия</country></aff><aff xml:lang="en"><institution>P. A. Herzen Moscow Research Oncological Institute National Medical Research Center of Radiology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Московский многопрофильный научно-клинический центр имени С. П. Боткина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>S. P. Botkin Moscow Regional Research and Clinical Center</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>06</day><month>08</month><year>2026</year></pub-date><volume>3</volume><issue>4</issue><fpage>43</fpage><lpage>52</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Будурова М.Д., Трифанов В.С., Мирзаев Т.С., Иконова К.А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Будурова М.Д., Трифанов В.С., Мирзаев Т.С., Иконова К.А.</copyright-holder><copyright-holder xml:lang="en">Budurova M.D., Trifanov V.S., Mirzaev T.S., Iconova K.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.oncocase.ru/jour/article/view/148">https://www.oncocase.ru/jour/article/view/148</self-uri><abstract><p>Дистальная холангиокарцинома (ДХК) (DCCA в англоязычной литературе) (С24.9 по МКБ-10) редкое злокачественное новообразование, возникающее из эпителиальных клеток дистальных отделов желчевыводящих путей, характеризующееся неблагоприятным прогнозом. ДХК часто протекает без клинических проявлений и манифестирует в стадии местно-распространенного или метастатического заболевания. Для пациентов с ранней стадией заболевания, с резектабельной опухолью хирургическая резекция с отрицательными краями резекции остается единственной эффективной стратегией лечения: общепризнанным стандартом хирургического лечения является операция ГПДР. Однако, несмотря на радикально выполненное хирургическое вмешательство, риск рецидива, прогрессирования ДХК остается высоким: почти у 50% пациентов рецидив заболевания развивается в течение 5 лет после радикальной операции. И поэтому целесообразно продолжать оптимизировать неоадъювантную и адъювантную терапию, чтобы снизить риск рецидива и улучшить общую выживаемость (ОВ) этой группы пациентов. В данном обзоре мы представим клиническое наблюдение пациента с ДХК с тяжелой сопутствующей сердечно-сосудистой патологией, которому выполнена радикальная резекция общего печеночного протока и общего желчного протока, холецистэктомия, формирование гепатико-энтероанастомоза на петле по Ру.</p></abstract><trans-abstract xml:lang="en"><p>Distal cholangiocarcinoma (DCCA) is a rare malignant neoplasm originating from the epithelial cells of the distal bile ducts and characterized by an unfavorable prognosis. DCCA often occurs without clinical manifestations and manifests itself at the stage of locally advanced or metastatic disease. For patients with early-stage disease and resectable tumors, surgical resection with negative resection margins remains the only effective treatment strategy: the generally accepted standard of surgical treatment is pancreaticoduodenal resection. However, despite the radical surgical intervention, the risk of recurrence and progression of DCCA remains high: in almost 50% of patients, the disease recurs for 5 years after surgery. Therefore, it is advisable to continue optimizing neoadjuvant and adjuvant therapy to reduce the risk of recurrence and improve the overall survival (OS) of this group of patients. In this review, we will present a clinical observation of a patient with DCCA, in a patient with severe concomitant cardiovascular pathology, who underwent radical resection of the common hepatic duct and common bile duct, cholecystectomy, and formation of a Roux-en-Y hepaticojejunostomy.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак дистального отдела холедоха</kwd><kwd>дистальная холангиокарцинома</kwd><kwd>резекция холедоха и общего печеночного протока</kwd><kwd>гепатико-еюноанастомоз на петле тонкой кишки по Ру</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cancer of the distal segment of the choledochus</kwd><kwd>resection of choledochus and hepaticus</kwd><kwd>Roux-en-Y hepaticojejunostomy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Gorji L., Beal E.W. Surgical Treatment of Distal Cholangiocarcinoma // Curr. Oncol . 2022. Sep 17. Vol. 29, No. 9. 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