Solovei G, Alame A, Petit J, Favriel J M, al Hareiss H, Glavier F, Cart P, Fauchart J P
Service de Chirurgie A, Hôpital Manchester, Charleville-Mezières.
Ann Radiol (Paris). 1993;36(2):161-5.
The authors report a case of fungating cholangiocarcinoma of the porta hepatis, revealed by jaundice in a 73-year-old cholecystectomized female. The diagnosis of obstruction of the hepatic duct junction suspected by ultrasonography and computed tomography was confirmed intraoperatively. Disobstruction was followed by laterolateral choledocoduodenostomy. An early recurrence required a second disobstruction with surgical then endoscopic insertion of a drain, with 23 months of satisfactory survival. The discussion is focused on hilar fungating cholangiocarcinoma. The extrahepatic (Klatskin tumor) or intrahepatic origin of these lesions, the circumstances and morphological investigations for the diagnosis are discussed. Particularities of the treatment are mentioned, with emphasis on the possible participation of the endoscopist for choledocho or hepaticoduodenostomy.
作者报告了一例肝门部溃疡性胆管癌病例，该病例由一名73岁行胆囊切除术的女性黄疸症状发现。超声和计算机断层扫描怀疑肝管交界处梗阻，术中确诊。解除梗阻后行胆总管十二指肠外侧吻合术。早期复发需要再次解除梗阻，先进行手术，然后内镜置入引流管，患者存活了23个月，情况良好。讨论集中在肝门部溃疡性胆管癌。探讨了这些病变的肝外（克氏壶腹肿瘤）或肝内起源、诊断的情况及形态学检查。文中提到了治疗的特殊性，重点强调了内镜医师在胆总管或肝十二指肠吻合术中可能发挥的作用。
