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卡洛里病患者肝内胆管癌的管理:一例报告及文献综述

Management of intrahepatic cholangiocarcinoma in a patient with Caroli's disease: a case report and literature review.

作者信息

Abouelwafa Omar, Lehwald-Tywuschik Nadja, Prassas Dimitrios, Knoefel Wolfram Trudo, Vaghiri Sascha

机构信息

Department of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, North Rhine-Westphalia, Germany.

Department of Surgery, AKH Viersen, Hoserkirchweg 63, 41747 Viersen, North Rhine-Westphalia, Germany.

出版信息

J Surg Case Rep. 2025 Aug 26;2025(8):rjaf380. doi: 10.1093/jscr/rjaf380. eCollection 2025 Aug.

Abstract

Caroli's disease is a rare congenital disorder characterized by cystic dilatations of the intrahepatic bile ducts, often leading to recurrent bacterial cholangitis, biliary lithiasis, and cirrhosis. In 7%-16% of cases, it progresses to intrahepatic cholangiocarcinoma, emphasizing the need for early diagnosis and intervention. This report presents a 56-year-old patient with recurrent upper abdominal pain, chronic fatigue, and night sweats. Imaging studies (computed tomography, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography) revealed dilated bile ducts and a hypodense lesion in the left hepatic lobe, prompting a left hemihepatectomy. Histopathological analysis confirmed a 12 cm mucinous, papillary cholangiocarcinoma. Postoperative follow-up showed no recurrence or metastasis. Treatment strategies depend on disease extent, with surgical resection being the preferred approach for localized disease, while liver transplantation remains the only curative option for bilateral involvement.

摘要

卡罗里病是一种罕见的先天性疾病,其特征为肝内胆管的囊性扩张,常导致复发性细菌性胆管炎、胆石症和肝硬化。在7% - 16%的病例中,它会发展为肝内胆管癌,这凸显了早期诊断和干预的必要性。本报告介绍了一名56岁的患者,有反复上腹部疼痛、慢性疲劳和盗汗症状。影像学检查(计算机断层扫描、内镜逆行胰胆管造影、磁共振胰胆管造影)显示胆管扩张以及左肝叶有一个低密度病变,于是进行了左半肝切除术。组织病理学分析证实为一个12厘米的黏液性乳头状胆管癌。术后随访未发现复发或转移。治疗策略取决于疾病范围,手术切除是局限性疾病的首选方法,而肝移植仍是双侧受累的唯一治愈选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3f8/12380465/0a98e72a86b4/rjaf380f1.jpg

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