Lauridsen Mette Enok Munk, Mortensen Frank V, Nielsen Dennis T, Grønbæk Henning
Medical Department V, Aarhus University Hospital, Noerrebrogade 44, DK-8000, Aarhus C, Denmark.
J Gastrointest Cancer. 2012 Jun;43(2):354-7. doi: 10.1007/s12029-010-9212-6.
Cholangiocellular carcinoma accounts for 3% of gastrointestinal tumors. It is the second most common primary hepatic malignancy and is associated with primary sclerosing cholangitis.
We report a patient with primary sclerosing cholangitis and cholangiocellular carcinoma who underwent partial hepatectomy and postoperatively suffered life-threatening biliary stasis with cholascos and peritonitis. The patient had cholangiocellular carcinoma recurrence at the resection margins and local lymph node metastases, but chemotherapy was not possible because of elevated bilirubin and liver dysfunction. After successful percutaneous stenting and placement of an internal-external drainage tube from the biliary tree to the gastric ventricle, ascites and cholascos resolved completely and the patient was then referred for chemotherapy. The internal-external drainage tube was converted to an internal tube after 3 1/2 months. The patient received chemotherapy and survived 14 months after stenting.
Preferably, bile leaks should be detected preoperatively but the ongoing development of solutions to the postoperative biliary complications seen in these patients is extremely important.
胆管细胞癌占胃肠道肿瘤的3%。它是第二常见的原发性肝脏恶性肿瘤，与原发性硬化性胆管炎相关。
我们报告了一名患有原发性硬化性胆管炎和胆管细胞癌的患者，该患者接受了部分肝切除术，术后出现危及生命的胆汁淤积伴胆汁外渗和腹膜炎。患者在切除边缘出现胆管细胞癌复发及局部淋巴结转移，但由于胆红素升高和肝功能不全无法进行化疗。在成功进行经皮支架置入并从胆管树到胃腔放置内外引流管后，腹水和胆汁外渗完全消退，随后患者被转诊接受化疗。3个半月后，内外引流管转换为内引流管。患者接受了化疗，支架置入后存活了14个月。
理想情况下，胆汁漏应在术前检测到，但针对这些患者术后胆道并发症不断研发解决方案极为重要。
