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胆管囊腺瘤的外科治疗。15例报告。

Surgical treatment of biliary cystadenoma. A report of 15 cases.

作者信息

Lewis W D, Jenkins R L, Rossi R L, Munson L, ReMine S G, Cady B, Braasch J W, McDermott W V

机构信息

Department of Surgery, Harvard Medical School, Boston, MA.

出版信息

Arch Surg. 1988 May;123(5):563-8. doi: 10.1001/archsurg.1988.01400290045007.

Abstract

Mucinous biliary cystadenomas are rare intrahepatic or, less commonly, extrahepatic neoplasms that may produce massive enlargement, hemorrhage, rupture, secondary infection, jaundice, or vena caval obstruction. Radiologic criteria differentiate biliary cystadenomas from more common parasitic or simple cysts. Treatment has included sclerosis, marsupialization, internal drainage, or resection, but without resection the patient is at risk for enlargement, infection, or progression of an unrecognized malignant neoplasm. We report the course of 15 patients who underwent resection for biliary cystadenoma to elucidate the clinical presentation, preoperative evaluation, and surgical treatment. Nine patients had had previous radiologic or surgical intervention other than excision, and complications of sepsis and tumor recurrence had developed. Following complete resection, however, only five postoperative complications were encountered, and no patient experienced recurrence of tumor. Thus, we recommend complete surgical resection as the preferred therapy.

摘要

黏液性胆管囊腺瘤是罕见的肝内肿瘤,较少见的为肝外肿瘤,可导致肝脏巨大肿大、出血、破裂、继发感染、黄疸或腔静脉梗阻。影像学标准可将胆管囊腺瘤与更常见的寄生虫性囊肿或单纯囊肿区分开来。治疗方法包括硬化治疗、袋形缝合术、内引流或切除术,但如果不进行切除,患者有未被识别的恶性肿瘤增大、感染或进展的风险。我们报告了15例接受胆管囊腺瘤切除术患者的病程,以阐明临床表现、术前评估和手术治疗情况。9例患者曾接受过除切除以外的放射学或手术干预,且出现了败血症和肿瘤复发等并发症。然而,在完整切除术后,仅出现了5例术后并发症,且无患者出现肿瘤复发。因此,我们建议将完整手术切除作为首选治疗方法。

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