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[酷似肝门部胆管癌的良性肝门狭窄]

[Benign hilar stenosis mimicking Klatskin tumor].

作者信息

Santoro R, Santoro En, Ettorre G M, Nicolas C, Santoro E

机构信息

Département de chirurgie cancérologique, institut Regina-Elena, 53, via E.-Chinesi, 00144 Rome, Italie.

出版信息

Ann Chir. 2004 Jun;129(5):297-300. doi: 10.1016/j.anchir.2004.02.010.

Abstract

Preoperative diagnosis of hilar carcinoma (Klatskin tumor) is usually done according to the only clinical and imaging findings. However, in 5-15% of patients operated with this diagnosis, hilar stenosis is an inflammatory pseudo-tumoral benign one. We reported the case of a patient who underwent resection of common bile duct for suspicion of hilar carcinoma in whom, despite clinical and imaging findings highly suggestive of malignancy, pathologic examination revealed aspecific cholangitis. After a review of the literature, we conclude that resection of common bile duct is mandatory to exclude malignancy and allows excellent biliary drainage. Associated major hepatectomy should ideally be indicated, due to its higher risks, after pathological confirmation of cholangiocarcinoma, if necessary by frozen section.

摘要

肝门部癌(克氏瘤)的术前诊断通常仅依据临床和影像学检查结果。然而,在以此诊断接受手术的患者中,有5% - 15%的患者其肝门部狭窄是炎性假瘤性良性病变。我们报告了一例因疑似肝门部癌而接受胆总管切除术的患者,尽管临床和影像学检查结果高度提示为恶性肿瘤,但病理检查显示为特异性胆管炎。在复习文献后,我们得出结论,胆总管切除术对于排除恶性肿瘤是必要的,并且能实现良好的胆道引流。由于风险较高,理想情况下,在胆管癌经病理证实后,如有必要可通过冰冻切片,再行相关的肝大部切除术。

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