Namdar Thomas, Raffel Andreas, Topp Stefan Andreas, am Esch Jan Schulte, Fürst Günther, Knoefel Wolfram Trudo, Eisenberger Claus Ferdinand
Department of General, Visceral and Pediatric Surgery, Heinrich-Heine University, Düsseldorf, Germany.
Hepatobiliary Pancreat Dis Int. 2009 Feb;8(1):103-5.
Cholangiocarcinoma (CC), the most common biliary tract malignancy, is frequently seen in advanced unresectable stages and is typically localized extrahepatically. Early diagnosis is unusual because of nonspecific symptoms. Painless jaundice is usually the first sign of tumor.
We present a patient with a CC (Klatskin tumor) with a complete biliary drainage by an aberrant bile duct without jaundice.
A 67-year-old woman presented with persisting elevation of liver parameters. Diagnostic tests showed a Klatskin tumor type II. A curative right hepatic trisegmentectomy was performed after liver volume augmentation by preoperative vein embolization.
A direct drainage of the right posterior bile duct into the common bile duct as an aberrant hepatic duct is a rare variation and is present in less than 5% of the population. In case of persistently perturbed liver function tests, an aberrant bile duct can cover up severe intrahepatic cholestasis and even obscure the diagnosis of a Klatskin tumor. Up to now it has not been described in the literature.
胆管癌（CC）是最常见的胆道恶性肿瘤，常见于晚期不可切除阶段，通常位于肝外。由于症状不具特异性，早期诊断并不常见。无痛性黄疸通常是肿瘤的首发症状。
我们报告一例患有CC（肝门部胆管癌）的患者，其通过一条异常胆管实现了完全胆道引流且无黄疸。
一名67岁女性出现肝功能指标持续升高。诊断检查显示为II型肝门部胆管癌。在术前通过静脉栓塞增加肝脏体积后，进行了根治性右半肝三段切除术。
右后胆管作为一条异常肝管直接引流至胆总管是一种罕见变异，在不到5%的人群中存在。在肝功能检查持续异常的情况下，异常胆管可能掩盖严重的肝内胆汁淤积，甚至模糊肝门部胆管癌的诊断。迄今为止，文献中尚未对此进行描述。
