原发性肝胆管结石与继发性肝胆管癌

探讨原发性肝胆管结石与肝胆管癌的关系。总结本病的诊治经验。方法对１９８１－１９９８年间收治的２０例原发性肝胆管结石术后并发肝胆管癌的病例进行回顾性临床分析。结果本组病人均有１０－４０年肝胆管结石病史，曾经过１－５次胆道手术。主要临床表现是反复胆管炎发作和持续右上腹疼痛。由于本病早期诊断困难，大多数病人在手术时已属晚期，５年生存率仅５％，８０％病人在术后１年内死亡。病理诊断大多为腺癌。结论原发性肝胆

Hepatolithiasis and secondary intrahepatic cholangiocarcinoma

Objective To probe into the relationship between the hepatolithiasis and the intrahepatic cholangiocarcinoma, and to summarize the experiences of diagnosis and treatment of these diseases. Method A retrospective clinical analysis was made in 20 cases of hepatolithiasis complicated by intrahepatic cholangiocarcinoma between 1981 and 1998. Results All patients had suffered from hepatolithiasis for 10 to 40 years, and had been subjected to operations for biliary diseases. The clinical features were recurrent attack of cholangitis and persistent right epigastric pain. Because early diagnosis was very difficult, most patients were of late stages on operations. The 5 year survival rate in this series of patients was 5% and about 80% of them died within 1 year after operation. By pathological classification most of them were adenocarcinomas. Conclusions Long term chronic inflammatory stimulation due to primary hepatolith and epithelial hyperplastic lesions are the causes inducing intrahepatic cholangiocarcinoma and early diagnosis and resection on time might improve the therapeutic effecacy.