Sharma B C, Bhasin D K, Sethi A, Vashishta R K, Gupta N M, Singh K
Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Trop Gastroenterol. 1999 Jul-Sep;20(3):140-1.
A 48 year old woman presented with obstructive jaundice 10 years back. Upper gastrointestinal endoscopy revealed a growth infiltrating the ampulla of Vater, which was confirmed to be adenocarcinoma on cytology. At laparotomy, a large nodular growth was seen in the head of pancreas. Surgical resection could not be done because of encasement of superior mesenteric vessels, hence a cholecystojejunostomy was performed. The patient remained asymptomatic for 9 years, when she developed cholangitis. Duodenoscopy at this stage revealed an ulcerated growth at the ampulla and biopsy from the growth confirmed a well differentiated adenocarcinoma. A straight flap 10 F stent was placed in the common bile duct. Thereafter the patient has remained asymptomatic for more than a year.
一名48岁女性10年前出现梗阻性黄疸。上消化道内镜检查发现一个肿物浸润十二指肠乳头，细胞学检查确诊为腺癌。剖腹探查时，发现胰头有一个大的结节状肿物。由于肠系膜上血管被包绕，无法进行手术切除，因此行胆囊空肠吻合术。患者9年来一直无症状，之后发生胆管炎。此时十二指肠镜检查发现十二指肠乳头有一个溃疡样肿物，肿物活检确诊为高分化腺癌。在胆总管置入一根10F直型覆膜支架。此后患者又保持无症状状态一年多。
