肝移植治疗胆管类癌肝转移。
Liver transplantation for metastases from a bile duct carcinoid.
机构信息
Division of General Surgery, Section of Transplantation and Hepatobiliary Surgery, McGill University Health Center, Montreal, Quebec, Canada.
出版信息
HPB (Oxford). 2006;8(1):67-8. doi: 10.1080/13651820600573170.
BACKGROUND
A 29-year-old woman who presented with fatigue and jaundice was found to have an obstructing mass at the bifurcation of the bile duct. The patient underwent a successful left hepatectomy with resection of the bile duct bifurcation and a reconstruction with a right hepaticojejunostomy. Pathology revealed an atypical carcinoid tumour of the left extrahepatic bile duct, with perineural and lymphatic invasion. The patient subsequently developed multiple metastases in the remaining liver.
METHODS
In the absence of extrahepatic disease, the patient underwent a successful liver transplant.
RESULTS
Two years later she remains disease-free.
DISCUSSION
To our knowledge this is the first report of a biliary carcinoid treated with hepatectomy and finally with liver transplantation, with excellent results. The biological behaviour of these rare tumours mandates aggressive surgical management.
背景
一位 29 岁女性因疲劳和黄疸就诊，发现胆管分叉处有阻塞性肿块。患者成功接受了左半肝切除术，切除了胆管分叉处，并进行了右肝管空肠吻合术。病理显示左肝外胆管非典型类癌，伴有神经周围和淋巴管浸润。随后，患者在剩余肝脏中出现多处转移。
方法
在没有肝外疾病的情况下，患者成功进行了肝移植。
结果
两年后，患者仍无疾病。
讨论
据我们所知，这是首例经肝切除术和最终肝移植治疗的胆管类癌病例，效果极佳。这些罕见肿瘤的生物学行为需要积极的手术治疗。
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