Okamura T, Murakami S, Nishioka Y, Hirayama R, Mishima Y, Awazu R
Second Department of Surgery, Tokyo Medical and Dental University, Japan.
Jpn J Surg. 1987 Jul;17(4):281-8. doi: 10.1007/BF02470701.
Benign neoplasms of the extrahepatic bile ducts are rare and there have only been thirteen reported cases of cystadenoma. One case of cystadenoma of the common hepatic duct and solitary hepatic cyst is presented here and a total of fourteen cases are reviewed. The patient was a 45 year old woman, who complained of abdominal pain with rigidity, but without jaundice. Ultrasonography of the liver showed a 6 cm cyst of the right lobe. Percutaneous transhepatic cholangiography revealed a multilobular cystic mass. At emergency laparotomy, a polypoid multilobular tumor with a stalk was found hanging from the common hepatic duct and was excised. Almost all the patients reported were middle age woman with jaundice. Preoperative diagnosis was made possible by percutaneous transhepatic cholangiography, endoscopic retrograde cholangiography or ultrasonography. The treatment of choice was complete excision. In three cases, a solitary hepatic cyst accompanied the cystadenoma of the common hepatic duct.
肝外胆管的良性肿瘤较为罕见,仅报告过13例囊腺瘤病例。本文介绍了1例肝总管囊腺瘤合并孤立性肝囊肿的病例,并对总共14例病例进行了回顾。患者为一名45岁女性,主诉腹痛伴腹肌紧张,但无黄疸。肝脏超声检查显示右叶有一个6厘米的囊肿。经皮肝穿刺胆管造影显示为多叶性囊性肿块。在急诊剖腹手术中,发现一个带蒂的息肉状多叶肿瘤从肝总管垂下并被切除。几乎所有报告的患者均为中年女性且伴有黄疸。术前通过经皮肝穿刺胆管造影、内镜逆行胆管造影或超声检查得以确诊。首选的治疗方法是完整切除。在3例病例中,肝总管囊腺瘤伴有孤立性肝囊肿。