Cherqui D, Palazzo L, Piedbois P, Charlotte F, Duvoux C, Duron J J, Fagniez P L, Valla D
Department of Digestive Surgery, Hôpital Henri Mondor, Créteil, France.
J Hepatol. 1994 Jun;20(6):693-7. doi: 10.1016/s0168-8278(05)80136-9.
We report the cases of two patients who developed symptomatic common bile duct stricture 10 years after upper abdominal radiotherapy for malignant lymphoma. Both patients were in complete remission and presented with marked obstructive jaundice. Endosonography was useful in both cases and showed segmental thickening of the bile duct wall narrowing in the lumen. Both patients underwent surgical exploration, confirming biliary obstruction due to intrinsic wall thickening, and had successful biliary drainage by Roux-en-Y hepatico-jejunostomy. Histological examination of the resected bile duct, in one case, and of a bile duct biopsy, in the other, was consistent with late irradiation injury. We conclude that stricture may be a delayed consequence of radiotherapy applied to normal bile ducts.
我们报告了两例患者的病例，他们在上腹部接受恶性淋巴瘤放射治疗10年后出现了有症状的胆总管狭窄。两名患者均处于完全缓解期，并表现出明显的梗阻性黄疸。内镜超声检查对两例患者均有用，显示胆管壁节段性增厚，管腔狭窄。两名患者均接受了手术探查，证实因固有壁增厚导致胆道梗阻，并通过Roux-en-Y肝空肠吻合术成功进行了胆道引流。一例患者切除的胆管组织学检查以及另一例患者的胆管活检组织学检查均与晚期放射损伤相符。我们得出结论，狭窄可能是对正常胆管进行放射治疗的延迟后果。
