Ogiso Takuya, Suzuki Hirotaka, Matsubara Hiroshi, Naito Takehito, Yamada Masahiro, Yamamoto Hideko, Hattori Shun, Aoba Taro, Arai Yoshifumi, Urano Fumihiro
Department of Gastroenterology Chutoen General Medical Center Shizuoka Japan.
Department of Gastroenterology Toyohashi Municipal Hospital Aichi Japan.
DEN Open. 2024 Aug 21;5(1):e70001. doi: 10.1002/deo2.70001. eCollection 2025 Apr.
Peribiliary glands are complex lobular structures containing mucus and serous glands, distributed along the extrahepatic and intrahepatic bile ducts. In this report, we describe a case of intraductal papillary neoplasm of the bile duct suspected to be of peribiliary glands origin. The patient was an 80-year-old man who was referred to our hospital for a hepatic mass. On further examination, a 38 × 34 mm cystic lesion with papillary growth was found in S1/4. Because the lesion was extensively bordered by both hepatic ducts and the connection was unclear, it was difficult to determine the extent of hepatic resection. To confirm the location, a peroral cholangioscopy was performed. The connection with the cyst was detected in the right hepatic duct and a villous tumor mucosa protruded through the conduit lumen. Since we found that the lesion communicated with the right hepatic duct, a right hepatectomy was subsequently performed. The postoperative pathological diagnosis was an intraductal papillary neoplasm of the blie duct with associated invasive carcinoma. The postoperative course was good, and the patient experienced no recurrence.
胆管周围腺体是包含黏液腺和浆液腺的复杂小叶结构，沿肝外和肝内胆管分布。在本报告中，我们描述了一例疑似起源于胆管周围腺体的胆管内乳头状肿瘤病例。患者为一名80岁男性，因肝脏肿物转诊至我院。进一步检查发现，在S1/4区域有一个38×34mm的伴有乳头状生长的囊性病变。由于该病变与肝管广泛毗邻且连接关系不清，难以确定肝切除范围。为明确病变位置，进行了经口胆管镜检查。在右肝管中检测到与囊肿的连接，并且有绒毛状肿瘤黏膜从导管腔突出。由于我们发现该病变与右肝管相通，随后进行了右半肝切除术。术后病理诊断为胆管内乳头状肿瘤伴浸润性癌。术后病程顺利，患者无复发。
