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肝内胆管囊腺瘤的诊断与治疗:单中心14例经验

Diagnosis and treatment of intrahepatic biliary cystadenoma: experience with 14 cases in a single center.

作者信息

Wang Kewei, Kong Fanmin, Dong Ming, Zhou Jianping, Li Yuji

机构信息

Department of Gastrointestinal Surgery, The First Affiliated Hospital of China Medical University, Shenyang, 110001, Liaoning, China.

出版信息

Med Oncol. 2014 Nov;31(11):274. doi: 10.1007/s12032-014-0274-3. Epub 2014 Oct 7.

Abstract

Intrahepatic biliary cystadenoma (IHBCA) is a rare type of liver tumor. There are no specific diagnostic methods for IHBCA, so its preoperative diagnostic rate is still fairly low. The aims of this study were to evaluate the clinical manifestations, diagnosis, and treatment of IHBCA. We retrospectively analyzed data from 14 patients treated in our hospital from January 2004 to April 2014. Eleven patients (78.6 %) were female, and the average age was 48.0 years (range 16-77 years). The most common clinical symptoms were abdominal discomfort (i.e., abdominal pain), reported in seven cases (50 %), and fullness after eating, reported in two cases (14.3 %). Jaundice was a less common symptom reported in one case (7.1 %). Four patients (28.6 %) were asymptomatic. Enhanced computed tomography (CT) scan showed multilocular or internal septations in 11 cases (78.6 %) and papillary projections or mural nodules on the cyst wall in one case (7.1 %). After injection of a contrast agent, the cyst walls or septations were slightly enhanced in nine cases (64.3 %). All 14 patients underwent surgical resection. Only one case showed recurrence (2 years postoperatively); the remaining 13 patients were recurrence-free. Intrahepatic biliary cystadenoma often occurs in middle-aged women. The main clinical symptoms are abdominal fullness with a sense of pain and jaundice. Enhanced CT is the main preoperative diagnostic method. Radical resection is the best treatment for IHBCA and can effectively prevent recurrence.

摘要

肝内胆管囊腺瘤(IHBCA)是一种罕见的肝脏肿瘤。目前尚无针对IHBCA的特异性诊断方法,因此其术前诊断率仍然相当低。本研究的目的是评估IHBCA的临床表现、诊断及治疗。我们回顾性分析了2004年1月至2014年4月在我院接受治疗的14例患者的数据。11例患者(78.6%)为女性,平均年龄为48.0岁(范围16 - 77岁)。最常见的临床症状为腹部不适(即腹痛),7例(50%)有此症状,进食后饱胀2例(14.3%)。黄疸是较少见的症状,1例(7.1%)出现。4例患者(28.6%)无症状。增强计算机断层扫描(CT)显示,11例(78.6%)为多房性或内部有分隔,1例(7.1%)在囊壁上有乳头状突起或壁结节。注射造影剂后,9例(64.3%)的囊壁或分隔有轻度强化。14例患者均接受了手术切除。仅1例出现复发(术后2年);其余13例无复发。肝内胆管囊腺瘤常发生于中年女性。主要临床症状为腹部饱胀伴疼痛感及黄疸。增强CT是主要术前诊断方法。根治性切除是治疗IHBCA的最佳方法,并可有效预防复发。

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