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避免全内脏转位患者十二指肠乳头腺癌的误诊:腹腔镜胰十二指肠切除术——1例罕见病例报告

Avoiding misdiagnosis of duodenal papilla adenocarcinoma in a situs inversus totalis patient laparoscopic pancreaticoduodenectomy: A rare case report.

作者信息

Liang Hao, Wu Ya-Kun, Pang Wu, Chen Ming-Liang, Zhu Yu

机构信息

Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, China.

出版信息

Front Surg. 2023 Jan 6;9:1058580. doi: 10.3389/fsurg.2022.1058580. eCollection 2022.

Abstract

Situs inversus totalis is a rare congenital anatomical anomaly that causes some difficult problems for surgeons when performing an operation. However, without histopathology specimens from surgery, a misdiagnosis of cancer may be unavoidable, in addition to affecting the improvement of prognosis. This study reports a rare patient with situs inversus totalis who presented with the main complaints of pruritus and vague abdominal pain. She was first misdiagnosed with cholangiocarcinoma and was finally diagnosed with duodenal papilla adenocarcinoma laparoscopic pancreaticoduodenectomy. Situs inversus totalis was not a contraindication for surgery. Skilled surgeons and complete preparation during the perioperative period are two important keys to successful surgeries. Performing laparoscopic pancreaticoduodenectomy for patients with situs inversus totalis to avoid misdiagnosis of cancer and tailor appropriate therapy plans is cost-effective.

摘要

全内脏转位是一种罕见的先天性解剖异常,在外科手术时会给外科医生带来一些难题。然而,若没有手术获取的组织病理学标本,除了影响预后改善外,癌症误诊可能难以避免。本研究报告了一名罕见的全内脏转位患者,其主要症状为瘙痒和腹部隐痛。她最初被误诊为胆管癌,最终经腹腔镜胰十二指肠切除术确诊为十二指肠乳头腺癌。全内脏转位并非手术禁忌证。技术娴熟的外科医生以及围手术期的充分准备是手术成功的两个关键因素。为全内脏转位患者施行腹腔镜胰十二指肠切除术以避免癌症误诊并制定合适的治疗方案具有成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25f0/9852054/6338be9a3d0e/fsurg-09-1058580-g001.jpg

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