肝内胆管囊腺瘤的诊治分析

目的：提高对肝内胆管囊腺瘤的认识。
方法：回顾性分析8年来收治的18例肝内胆管囊腺瘤患者的临床表现、影像特点及外科治疗的方式。
结果：4例为体检发现,其他14例均有不同症状,主要表现为右上腹不适或疼痛11例,腹部肿块3例,伴有黄疸发热等胆管炎症状2例。B超和CT提示肝内囊性占位性病变,可呈多囊或单囊,内壁可见乳头状物。均获得手术切除,18例肝内胆管囊腺瘤中6例发生癌变。 癌变者术后平均生存时间为35个月(27-58个月)。
结论：术前确诊肝内胆管囊腺瘤困难,肝内胆管囊腺瘤易恶变,发现后应早期手术切除,可有效防止复发或恶变。

Analysis of diagnosis and treatment of intrahepatic biliary cystadenoma

ObjectiveTo improve the recognition of intrahepatic biliary cystadenoma.
MethodsThe clinical manifestations,radiologic features,diagnosis and surgical treatment of 18 patients with intrahepatic biliary cystadenoma admitted in our hospital during the recent 8 years were retrospectively analyzed.
ResultsFour cases were discovered by general medical examination, while the other 14 patients had varying symptoms that included right upper abdominal discomfort or pain in 11 cases, abdominal mass in 3 cases,and jaundice accompanied by fever in 2 cases. B ultrasound and CT scan showed intrahepatic cystic occupying lesions consisting of multilocular or single cyst,and usually with papillary structures in the cyst wall. All of 18 cases received surgical resection. The patholgic dingnosis was intrahepatic biliary cystadenoma in all the 18 cases, and 6 of them showed malignant change.The average survival time of maligmant patients was 35(27-58)months.
ConclusionsPreoperative diagnosis of intrahepatic biliary cystadenoma is difficult.Intrahepatic biliary cystadenoma is easy to develop into cystadenocarcinoma. Early surgical resection is necessary, and can effectively prevent recurrence or malignant transformation.