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[1例胰腺黏液癌侵犯胆总管并伴有梗阻性黄疸]

[A case of pancreatic mucinous carcinoma invading the common bile duct with obstructive jaundice].

作者信息

Nakamura Noriaki, Irie Takumi, Tanaka Shinji, Teramoto Kenichi, Arii Shigeki

机构信息

Department of Hepato-biliary Pancreatic Surgery, Tokyo Medical and Dental University, Japan.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2012 Oct;109(10):1799-806.

Abstract

A 75-year-old man was admitted to our hospital for further investigation of obstructive jaundice due to a mucin-producing bile duct tumor. ERCP revealed dilatation of the common bile duct and a filling defect in the bile duct. Because of obstructive jaundice, an EBD tube was placed and bile was drained. Contrast-enhanced CT showed a low density 2-cm mass, in the pancreatic head containing some enhanced parts in the tumor. MRI revealed the tumor to be a low-intensity mass on T2-weighted image. After recovery from the obstructive jaundice, pancreaticoduodenectomy was performed under a diagnosis of invasive mucinous carcinoma penetrating the common bile duct from the pancreatic head, resulting in obstruction of the common bile duct. Postoperatively histopathological diagnosis of the resected specimen showed mainly mucinous carcinoma originating from the pancreatic head without a component of intraductal papillary-mucinous tumor.

摘要

一名75岁男性因黏液性胆管肿瘤导致梗阻性黄疸入院接受进一步检查。内镜逆行胰胆管造影(ERCP)显示胆总管扩张,胆管内有充盈缺损。由于梗阻性黄疸,放置了内镜鼻胆管引流管(EBD)进行胆汁引流。增强CT显示胰头有一个2厘米的低密度肿块,肿瘤内有一些强化区域。磁共振成像(MRI)显示该肿瘤在T2加权图像上为低强度肿块。梗阻性黄疸恢复后,在诊断为胰头浸润性黏液癌穿透胆总管导致胆总管梗阻的情况下,进行了胰十二指肠切除术。术后对切除标本的组织病理学诊断显示主要为起源于胰头的黏液癌,无导管内乳头状黏液性肿瘤成分。

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