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[胆管扩张合并胆管癌一例报告]

[A case report of cholangiectasis with cholangiocarcinoma].

作者信息

Nagata Tomoyuki, Ikoma Hisashi, Komiyama Sousuke, Nishio Minoru, Murayama Yasutoshi, Komatsu Shuuhei, Shiozaki Atsushi, Kuriu Yoshiaki, Nakanishi Masayoshi, Ichikawa Daisuke, Fujiwara Hitoshi, Okamoto Kazuma, Ochiai Toshiya, Sakakura Chouhei, Kokuba Yukihito, Sonoyama Teruhisa, Otsuji Eigo

机构信息

Dept. of Digestive Surgery, Kyoto Prefectural University of Medicine Graduate School of Medical Science.

出版信息

Gan To Kagaku Ryoho. 2011 Nov;38(12):2429-32.

Abstract

This is a case report of cholangiectasis with cholangiocarcinoma in a 37-year-old female. Both computed tomography (CT) and endoscopic retrograde cholangio-pancreatography (ERCP) demonstrated gallstone, and intrahepatic bile duct dilatation with the stone. The diagnosis was intrahepatic cholangiectasis without common bile duct-dilatation. Hepatectomy of segment 3 with resection of the extrahepatic bile duct and reconstruction of the biliary tract was performed. Upon pathological examination, an early stage of cholangiocarcinoma was pointed out within the small range of common bile duct without dilatation or stone. Cholangiocarcinoma with cholangiectasis has been reported to be induced by counter flow of pancreas and intestinal juice because of the pancreaticobiliary maljunction. So we usually choose a diversion operation as our tactics to get rid of the counter flow of those digestive juices. Despite the above-mentioned tendency, this is a very rare case of carcinogenesis in common bile duct without dilatation.

摘要

这是一例37岁女性胆管扩张合并胆管癌的病例报告。计算机断层扫描(CT)和内镜逆行胰胆管造影(ERCP)均显示有胆结石,以及伴有结石的肝内胆管扩张。诊断为无胆总管扩张的肝内胆管扩张。实施了3段肝切除术,同时切除肝外胆管并进行胆道重建。病理检查显示,在未扩张或无结石的胆总管小范围内发现了早期胆管癌。据报道,由于胰胆管合流异常,胰液和肠液逆流可诱发胆管扩张合并胆管癌。因此,我们通常选择转流手术来消除这些消化液的逆流。尽管有上述倾向,但这是一例非常罕见的未扩张胆总管发生癌变的病例。

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