Bruggen J T, McPhee M S, Bhatia P S, Richter J M
Dig Dis Sci. 1986 Aug;31(8):840-6. doi: 10.1007/BF01296053.
Primary bile duct carcinoma is a malignancy with a poor prognosis, but recent diagnostic developments allow earlier detection and possibly improved chances for effective palliation or surgical cure. In order to increase the clinical understanding and awareness of this disorder, 43 patients with primary adenocarcinoma of the bile ducts were reviewed. The mean patient age was 63, and symptoms of nausea, abdominal pain, and pruritus were reported in a majority of patients. Documented weight loss, alcoholic stools, cutaneous icterus, and hepatomegaly were each present in a majority of patients. Serum bilirubin and alkaline phosphatase determinations were abnormal in 40 of 43 patients (93%), and cholangiography was the diagnostic study providing the most discriminating information. Locally invasive disease and biliary obstruction was the major cause of morbidity and mortality, and there was only one surgical cure. These data suggest that cholangiography and nonsurgical techniques for biliary drainage should be employed in most patients who are not optimal surgical candidates.
原发性胆管癌是一种预后较差的恶性肿瘤，但近期诊断技术的发展使得能够更早地检测到该病，并且可能提高有效缓解或手术治愈的几率。为了增强对这种疾病的临床理解和认识，对43例原发性胆管腺癌患者进行了回顾性研究。患者的平均年龄为63岁，大多数患者报告有恶心、腹痛和瘙痒症状。大多数患者都有体重减轻、脂肪泻、皮肤黄疸和肝肿大的记录。43例患者中有40例（93%）血清胆红素和碱性磷酸酶测定异常，胆管造影是提供最具鉴别性信息的诊断性检查。局部浸润性疾病和胆管梗阻是发病和死亡的主要原因，只有1例手术治愈。这些数据表明，对于大多数不适合手术的患者，应采用胆管造影和非手术胆管引流技术。
