期刊文献+

肝外胆管腺瘤(2例报道及文献复习) 预览 被引量:10

Adenomas of Extrahepatic Bile Duct:Report of Two Cases and Review of the Literatures
在线阅读 下载PDF
分享 导出
摘要 目的探讨肝外胆管腺瘤的临床表现、病理特征、影像学特征及其诊断和治疗.方法对我院收治的2例及复习文献报告的14例共16例临床资料进行回顾性分析.结果男5例,女11例,平均年龄58.4岁,其中>50岁者占87.5%.主要临床表现:黄疸11例(68.8%),腹痛8例(50.0%),发热6例(37.5%),消化不良4例(25.0%),体重下降3例(18.8%),陶土色大便1例(6.3%).肿瘤分布部位为左肝管1例(6.3%),右肝管3例(18.8%),肝总管3例(18.8%),胆囊管汇入胆总管处1例(6.3%),胆总管远端8例(50.0%).病理类型为管状腺瘤5例(31.3%),乳头(绒毛)状腺瘤10例(62.5%),粘液腺瘤1例(6.3%).16例均行手术治疗,均经病理检查确诊,术后肿瘤复发1例.结论肝外胆管腺瘤缺乏典型的临床表现,术前难以确诊,必须依靠病理组织学检查.手术完整切除肿瘤,切缘无肿瘤残留是治疗的关健,术后应进行定期随访. Objective To study the clinical manifestations, pathologic characteristics, imaging features, diagnosis and treatment of adenomas of extrahepatic bile duct.Methods Two cases of adenomas of extrahepatic bile duct in our hospital and 14 cases reported in the literatures were analyzed retrospectively.Results The patients’(male 5, female 11) mean age was 58.4 years (range 21-85). The main manifestations included jaundice ( n =11), abdominal pain ( n =8),fever ( n =6), dyspepsia ( n =4),body weight loss ( n =3) and clay colored stool ( n =1). The locations of tumors were in the left hepatic duct ( n =1), right hepatic duct ( n =3), hepatic common bile duct( n =3),the junction of cystic duct and common bile duct ( n =1),distal common bile duct ( n =8). The pathologic types were tubular adenomas ( n =5), papillary (villous) adenomas ( n =10),and mucous adenoma ( n =1). All the patients underwent surgical therapy. The tumors were identified by postoperative histopathologic examination.Conclusion It is difficult to correctly diagnose adenomas of extrahepatic bile duct before operation, because the clinical manifestations are usually atypical. The definite diagnosis should depend on histopathologic examination. It is the key to completely resect the tumors. Postoperative follow up should be done on regular basis.
作者 李波 刘续宝 严律南 李宁 LI Bo, LIU Xu bao, YAN Lü nan, LI Ning. Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
出处 《中国普外基础与临床杂志》 CAS 2004年第3期 242-246,共5页 Chinese Journal of Bases and Clinics In General Surgery
关键词 肝外胆管腺瘤 临床表现 病理特征 影像学特征 诊断 治疗 Bile duct tumor Diagnosis Treatment
  • 相关文献

参考文献14

  • 1Bhatbal PS,Hughes NR,Goodman ZD.The so-called bile duct adenoma is a peribiliary gland hamartoma [J].Am J Surg Pathol,1996; 20(7) :858 被引量:1
  • 2Saxe J,Lucas C,Ledgerwood AM,et al.Villous adenoma of the common bile duct [J].Arch Surg,1998; 123(1) :96 被引量:1
  • 3Jae HL,Chin AY,Hyo KL,et al.Radiology spectrum of intraductal papillary tumors of the bile duct [J].Korean J Radio,2002; 3(1):57 被引量:1
  • 4Harshfield DL,Teplick SK,Stanton M,et al.Obstructing villous adenoma and papillary adenomatosis of the bile ducts [J].AJR Am J Roentgenol,1990; 154(6):1217 被引量:1
  • 5Kim HJ,Kim MH,Lee SK,et al.Mucin-hypersecreting bile duct tumor characterized by a striking homlolgy with an intraductal papillary mucinous (IPMT) tumor of the pancreas [J].Endoscopy,2000; 32(5):389 被引量:1
  • 6Oshikiri T,Kashimura N,Katanuma A,et al.Mucin-secreting bile duct adenoma --clinicopathological resemblance to intraductal papillary mucinous tumor of the pancreas [J].Dig Surg,2002; 19(4):324 被引量:1
  • 7Jennings PE,Rode J,Coral A,et al..Villous adenoma of the common hepatic duct:the role of ultrasound in management [J].Gut,1990; 31(5):558 被引量:1
  • 8Doudy G,Olin WG,Shelton E,et al.Benign tumor of the extrahepatic bile ducts:reports of three cases and review of the literature[J].ArchSurg,1962; 85(3):503 被引量:1
  • 9Kawakatsu M,Vilgrain V,Zins M,et al.Radiology features of papillary adenoma and papillomatosis of the biliary tract [J].Abdom Imaging,1997; 22(1):87 被引量:1
  • 10Styne P,Warren GH,Kumpe DA,et al.Obstructive cholangitis secondary to mucus secreted by a solitary papillary bile duct tumor [J].Gastroenterology,1986; 90(3):748 被引量:1

共引文献1

同被引文献22

  • 1谭群亚,司马军,何琳.胆总管下段良性肿瘤一例[J].中华普通外科杂志,2007,22(6):423-423. 被引量:1
  • 2袁涛 金世龙.胆总管下端乳头状腺瘤2例报告[J].中国普外临床基础杂志,1999,6(5):287-287. 被引量:2
  • 3Chijiiwa K,Koga A,Surgical management and long term follow up of patients with choledochal cysts.Am J Surg,1993,165:238-242. 被引量:1
  • 4Kawakatsu M,Vilgrain V,Zins M,et al.Radiologic features of papillary adenoma and papillomatosis of the biliary tract.Abdom Imaging,1997,22:87-90. 被引量:1
  • 5黄晓强 蔡守明 黄志强 等.胆总管下端良性肿瘤局部切除方法的改进[J].中华外科杂志,2000,5:328-328. 被引量:3
  • 6Asakawa T,Terada M, Oshibuchi H, et al. Large benign polyp of the extrahepatic bile duct (mimicking bile duct cancer)[J].Acta Med Nagasaki,2001,46(1 ):77-81. 被引量:1
  • 7Pasanen PA,Partanen KP,Pikkarainen PH,et al.A comparison of ultrasound,computed tomography and endoscopic retrograde cholangiopancreatography in the differential diagnosis of benign and malignant jaundice and cholestasis [J].Eur J Surg,1993,159(1):23-29. 被引量:1
  • 8Buckley JG,Salimi Z. Villous adenoma of the common bileduct[J].{H}ABDOMINAL IMAGING,1993.245-246. 被引量:1
  • 9黄洁夫.肝脏胆道肿瘤外科学[M]{H}北京:人民卫生出版社,1999770-773. 被引量:1
  • 10Dowdy GS,Olin WG,Shelton EL. Benign tumors of the extrahepatic bile ducts.Report of three cases and review of the literature[J].{H}Archives of Surgery,1962.503-513. 被引量:1

引证文献10

二级引证文献6

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈