先天性胆总管囊肿癌变的临床研究

目的探讨先天性胆总管囊肿癌变的临床特点、治疗方法及预后分析。方法回顾性分析我院手术治疗的11例先天性胆总管囊肿癌变的临床资料。结果先天性胆总管囊肿癌变9例，内引流术后癌变2例。年龄、黄疸、体重减轻、总胆红素（TB）、糖类抗原（CA）19—9对于胆总管囊肿是否癌变差异有统计学意义。手术方式、周围脏器侵犯、淋巴结转移、术后免疫治疗对于胆总管囊肿癌变病人预后有明显影响。结论年龄、胰胆管汇合异常是胆总管囊肿癌变发生的危险因素；而黄疸、体重减轻、TB升高、CA19—9升高等因素有助于早期诊断胆总管囊肿癌变。该病预后不佳，根治性手术结合辅助治疗有助于改善预后。

Malignant changes of congenial choledochal cyst

Objective To explore the climcal feature, treatment and prognosts tor mattgnant changes of congenial choledochal cyst. Methods The clinical data of 11 surgical cases of congenial cho- ledochal cyst from January 2003 to January 2013 were retrospective analyzed. Results Among them, there were synchronous （n = 9） and metachronous （n = 2） carcinoma lesions. The incidences of malignant changes of congenial choledochal cyst were closely related with age, jaundice, marasmus, total bilirubin （TB） and CA19-9. Surgical approach, adjacent organ invasion, lymph node metastasis and postoperative immunotherapy had significant effects on the prognosis for malignant changes of congenial choledochal cyst. Conclusions Age and eholedoehopancreatic junction anomaly are risk factors for malignant changes of congenial choledoehal cyst. Jaundice, marasmus, elevated TB and CA19-9 may aid an early diagnosis. The prognosis is poor. Radical resection plus adjunctive therapy may improve the prognosis.