术前精确定位指导肝内胆管囊腺瘤的治疗3例  

THE ROLE OF PREOPERATIVE ACCURATE LOCATION IN THE SURGICAL TREATMENTS OF INTRAHEPATIC BILIARY CYSTADENOMA:REPORT OF THREE CASES

作　　者：李强[1] 孙喜太[1] 周建新[1] 丁义涛[1] 

机构地区：[1]南京大学医学院附属南京鼓楼医院肝胆外科,南京210008

出　　处：《肝胆外科杂志》2011年第2期105-107,共3页Journal of Hepatobiliary Surgery

摘　　要：目的观察肝内胆管囊腺瘤的临床、影像、病理及外科治疗特点,探讨该病的临床诊疗方法。方法对2005年1月~2009年1月收治的3例肝内胆管囊腺瘤病例的临床表现、影像特点、诊疗策略及效果进行回顾性分析。结果 3例患者中2例男性、1例女性,临床上均表现为上腹痛,黄疸等症状;通过B超、MRCP及ERCP等手段予以肿瘤的精确定位,分别采用肝叶切除及胆道引流,均取得良好疗效。结论肝内胆管囊腺瘤临床症状不典型、术前明确诊断较为困难。精确定位对于肝内胆管囊腺瘤治疗策略的制定至关重要。完整切除肿瘤是最佳治疗方案,可有效防止其复发及恶变;全肝弥漫性多发囊腺瘤可以通过胆道引流得到较好的短期疗效,是肝移植的良好适应症。Objectives To explore the role of preoperative accurate location in the surgical treatments of intrahepatic biliary cystadenoma by means of clinical presentation,imaging features and pathology.Methods From January 2005 to January 2009,three patients with intrahepatic biliary cystadenoma were treated in the hospital.The clinical manifestations,imaging feathers,treatment strategies and results were analyzed retrospectively.Results Three patients（1 woman,2 men） all presented epigastric pain,jaundice and other symptoms.With the accurate localization of the neoplasms by abdominal ultrasound（US）,magnetic resonance cholangiopancreatography（MRCP） and endoscopic retrograde cholangiopancreatography（ERCP）,the treatment of hepatic lobectomy or biliary drainage were adopted to achieve good effects respectively.Conclusions Due to the atypical clinical symptoms which make it difficult to have a definitive preoperative diagnosis,accurate location of intrahepatic biliary cystadenoma is of vital importance for making surgical decisions.Total excision of the lesions remains the best treatment,which can effectively minimize the risk of local recurrence and malignant transformation.Biliary drainage can achieve better short term effect in diffuse multiple hepatic cystadenoma which is a good indication for liver transplantation.

关 键 词：术前精确定位 肝内胆管囊腺瘤 肝脏切除 胆道引流 

分 类 号：R735.8[医药卫生—肿瘤]