Yeung Yuk Pang, AhChong Kian, Chung Chi Kin, Chun Andrew Yip Wai
Department of Surgery, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong, PR China.
J Hepatobiliary Pancreat Surg. 2003;10(5):390-5. doi: 10.1007/s00534-002-0837-0.
Biliary papillomatosis is rare. Before 1993, there were only 21 cases reported in the English literature. This article reports our experience in managing this disease and reviews experiences from recent English literature. A retrospective review of patients with biliary papillomatosis was conducted in our institution. A search of the English literature between 1993 and 2002 was performed in the MEDLINE database using "biliary papillomatosis" as the keyword. Seven patients with biliary papillomatosis were treated in our hospital. Another 50 cases were reported in the recent literature. This amounted to a total of 78 cases so far reported. The male to female ratio was approximately 2 : 1. The mean age at presentation was 63 years. Most patients presented typically with cholangitis. Malignant change was present in 33 patients (42%). Concomitant intrahepatic and extrahepatic disease was noticed in 33 patients (42%). The overall resection rate was 55%. The mean survival was 28 months following resection, irrespective of histological type. Patients without tumor resection had a poorer survival of less than 11 months. Biliary papillomatosis presents typically with biliary obstruction and it occurs most often in elderly males. Resection is recommended because of the considerable malignancy rate, diffuse pattern of disease, and better survival following curative surgery. Malignant histology is not always associated with a poorer prognosis provided that radical resection can be achieved.
胆管乳头状瘤病较为罕见。1993年以前，英文文献中仅报道过21例。本文报告了我们在处理该疾病方面的经验，并回顾了近期英文文献中的相关经验。我们机构对胆管乳头状瘤病患者进行了回顾性研究。使用“胆管乳头状瘤病”作为关键词，在MEDLINE数据库中检索了1993年至2002年的英文文献。我院治疗了7例胆管乳头状瘤病患者。近期文献中又报道了50例。至此，总共报道了78例。男女比例约为2∶1。就诊时的平均年龄为63岁。大多数患者典型表现为胆管炎。33例患者（42%）发生了恶变。33例患者（42%）同时存在肝内和肝外病变。总体切除率为55%。无论组织学类型如何，切除术后的平均生存期为28个月。未接受肿瘤切除的患者生存期较差，不到11个月。胆管乳头状瘤病典型表现为胆管梗阻，最常发生于老年男性。鉴于其恶变率较高、疾病呈弥漫性以及根治性手术后生存期更佳，建议进行切除手术。只要能够实现根治性切除，恶性组织学改变并不总是与较差的预后相关。
