Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China.
World J Surg Oncol. 2013 Feb 1;11:30. doi: 10.1186/1477-7819-11-30.
We report a case of papillary carcinoma of the duodenum combined with right renal carcinoma. A 58-year-old man underwent a physical examination that revealed intrahepatic and extrahepatic bile duct dilatation on B ultrasound. Intrahepatic bile duct dilatation could be seen on magnetic resonance imaging (MRI), but the head of the pancreas and distal bile duct showed no tumor signals, which led to a diagnosis of periampullary carcinoma and right renal carcinoma. Considering the trauma of pancreaticoduodenectomy combined with renal resection operation is greater, we carried out the laparoscopic right renal radical resection first, and then a pylorus-preserving pancreaticoduodenectomy was performed. However, postoperative intra-abdominal infections and bleeding occurred; our patient improved after vascular interventional microcoil embolization for the treatment of hemostasis. The second operation for celiac necrotic tissue elimination, jejunal fistulization and peritoneal lavage and drainage was performed 14 days latter. Our patient improved gradually and was discharged on the 58th postoperative day. There has been no tumor recurrence after a follow-up of 26 months.
我们报告 1 例十二指肠乳头癌合并右肾癌病例。1 例 58 岁男性因体检行 B 超检查发现肝内外胆管扩张,磁共振成像(MRI)可见肝内胆管扩张,但胰头及胆总管下段未见肿瘤信号,诊断为壶腹周围癌及右肾癌。考虑胰十二指肠切除术联合肾切除术创伤较大,先行腹腔镜下右肾癌根治术,后行保留幽门的胰十二指肠切除术。但术后出现腹腔内感染和出血,经血管介入微弹簧圈栓塞治疗止血后患者病情改善。术后 14 天再次行剖腹坏死组织清除、空肠造瘘及腹腔冲洗引流术,患者逐渐好转后于术后第 58 天出院。随访 26 个月无肿瘤复发。