Benchellal Zine Abedine, Soro Kountélé Gona, Orain Isabelle, Poret Hélène, Ferhi Abd Hak, Darquies-Chevalley Julien
Department of Digestive Surgery, University Hospital Center of Tours, Tours, France.
Case Rep Gastroenterol. 2008 Sep;2(3):428-32. doi: 10.1159/000163396. Epub 2008 Nov 14.
Cystic duct carcinoma is known to have a better prognosis compared to its location in other biliary ducts. Only one case with a survival over ten years has been previously published. The authors report a case of survival over 13 years without recurrence or metastasis. Preoperative diagnosis of cystic duct tumor was carried in a 66-year-old male. Under the diagnosis of carcinoma of the cystic duct, the patient underwent en bloc resection of the gallbladder, cystic duct, hepaticocholedochus and lymph node dissection. A Roux-en-Y hepaticojejunostomy was performed. Histological examination revealed a moderately differentiated adenocarcinoma of the cystic duct. Five months later the patient underwent second look surgery for benign obstruction of the hepaticojejunal anastomosis. The patient is still doing well 13 years later without any local recurrence or metastasis. To our knowledge, this is the longest disease-free survival ever published in the literature. This case sustains that better and longer survival is possible with a real chance of potential cure if radical surgery is performed.
已知胆囊管癌与其在其他胆管部位相比预后较好。此前仅发表过一例存活超过十年的病例。作者报告了一例存活超过13年且无复发或转移的病例。对一名66岁男性进行了胆囊管肿瘤的术前诊断。在胆囊管癌的诊断下,患者接受了胆囊、胆囊管、肝总管整块切除及淋巴结清扫术。进行了Roux-en-Y肝空肠吻合术。组织学检查显示为胆囊管中度分化腺癌。五个月后,患者因肝空肠吻合口良性梗阻接受了二次探查手术。13年后患者仍状况良好,无任何局部复发或转移。据我们所知,这是文献中报道的最长无病生存期。该病例表明,如果进行根治性手术,有可能获得更好、更长的生存期并有真正治愈的机会。