Downey R S, Sicard G A, Lee J T, DeSchryver K, Anderson C B
Surgery. 1986 Jul;100(1):113-7.
Painless obstructive jaundice is usually the result of malignant compression of the distal common bile duct. Infrequently extrinsic benign lesions may also cause ductal obstruction and be mistaken for a malignant process. A case of compression of the distal common bile duct is described. Preoperative evaluation was most consistent with a cystadenocarcinoma of the head of the pancreas. At operation we found an enlarged and calcified periductal lymph node with associated fibrosis and compression and obstruction of the distal common duct. Massive dilatation of the distal common duct and the cystic duct remnant gave it the appearance of a cystic mass in the superior border of the head of the pancreas. Resection and choledochoduodenostomy were curative.
无痛性梗阻性黄疸通常是胆总管远端恶性压迫的结果。外在良性病变也可能偶尔导致胆管梗阻,并被误诊为恶性病变。本文描述了一例胆总管远端受压的病例。术前评估最符合胰头囊腺癌。手术中我们发现一个肿大并钙化的胆管周围淋巴结,伴有纤维化,导致胆总管远端受压和梗阻。胆总管远端和胆囊管残端的大量扩张使其在胰头上缘呈现出囊性肿块的外观。切除并进行胆总管十二指肠吻合术治愈了该疾病。