Abstract: This paper presents a case of a 43-year-old male diagnosed with left lobe intrahepatic cholangiocarcinoma following the detection of a left hepatic mass during a routine physical examination. Imaging evaluations confirmed tumor invasion into the middle hepatic vein, inferior vena cava, and hilar lymph nodes, leading to an initial assessment of unresectable disease. Following a multidisciplinary team （MDT） discussion, the patient was initiated on neoadjuvant therapy consisting of Gemcitabine/Cisplatin/Albumin-bound paclitaxel chemotherapy combined with sintilimab immunotherapy. Following four cycles of conversion therapy, the tumor significantly shrank, and the tumor marker CA19-9 markedly decreased, creating an opportunity for curative surgery.Subsequently, the patient successfully underwent extended left hepatectomy, caudate lobectomy,and regional lymph node dissection. Postoperative pathological examination confirmed an R0 resection. The patient recovered well postoperatively and continued adjuvant therapy. Over a follow-up period exceeding 24 months, no evidence of tumor recurrence was identified, and the patient maintained a favorable quality of life. This case suggests that chemotherapy combined with immunotherapy as a neoadjuvant approach can effectively convert initially unresectable locally advanced intrahepatic cholangiocarcinoma, providing patients with an opportunity for curative surgery and survival benefits.

Key words: intrahepatic cholangiocarcinoma, conversion therapy, chemotherapy, immunotherapy

摘要： 本文报道了1例43岁男性,因体检发现左肝占位确诊为肝左叶胆管细胞癌,影像学显示肿瘤已侵犯中肝静脉、下腔静脉及肝门淋巴结,初诊评估为不可切除。经多学科讨论,患者接受了吉西他滨/顺铂/白蛋白紫杉醇化疗联合信迪利单抗免疫治疗。4个周期的转化治疗后,肿瘤显著缩小,肿瘤标志物CA19-9明显下降,获得了根治性手术机会。随后,患者成功施行了扩大左半肝、尾状叶切除及区域淋巴结清扫术,术后病理证实为R0切除。患者术后恢复良好,继续接受辅助治疗,随访24个月余未见复发,生活质量良好。本病例提示,化疗联合免疫治疗作为新辅助方案,可有效转化初始不可切除的局部晚期肝内胆管细胞癌,为患者创造根治性手术机会并带来生存获益。

关键词: 肝内胆管癌, 转化治疗, 化疗, 免疫治疗