Kohya Naohiko, Hashiguchi Kazuyoshi, Yakabe Tomomi, Miyoshi Atsushi, Ohtsuka Takao, Kitahara Kenji, Miyazaki Kohji
Dept. of Surgery, Saga University Faculty of Medicine.
Gan To Kagaku Ryoho. 2009 Oct;36(10):1753-5.
A 66-year-old woman was admitted to our hospital because of general fatigue and icterus. PTC findings showed irregular stenosis of hilar bile duct. Abdominal CT scan showed a dilatation of the intra-hepatic bile duct and a tumor around hilar bile duct. We diagnosed it as hilar bile duct carcinoma, and although we operated it was unresectable because of the metastasis of a para-aorta lymph node and duodenal invasion. We started chemo-radiotherapy with a total dose of 45 Gy and gemcitabine. The tumor and para-aorta lymph node were remarkably decreased, and tumor marker CA 19-9 was also decreased to within the normal range. The patient had a peritoneal dissemination 10 months after the chemo-radiotherapy and survived 20 months.
一名66岁女性因全身乏力和黄疸入住我院。经皮肝穿刺胆管造影（PTC）结果显示肝门部胆管不规则狭窄。腹部CT扫描显示肝内胆管扩张以及肝门部胆管周围有肿瘤。我们将其诊断为肝门部胆管癌，尽管进行了手术，但由于腹主动脉旁淋巴结转移和十二指肠侵犯，肿瘤无法切除。我们开始进行化疗放疗，总剂量为45 Gy，并使用吉西他滨。肿瘤和腹主动脉旁淋巴结明显缩小，肿瘤标志物CA 19-9也降至正常范围内。化疗放疗10个月后患者出现腹膜播散，存活了20个月。
