Kato M, Nimura Y, Kamiya J, Kondo S, Nagino M, Miyachi M, Kanai M, Igaki H, Maeda S
First Department of Surgery, Nagoya University School of Medicine, Japan.
Am Surg. 1997 Nov;63(11):943-7.
A 54-year-old woman presented with jaundice. Percutaneous transhepatic biliary drainage, cholangiography via a percutaneous transhepatic biliary, drainage catheter, and percutaneous transhepatic cholangioscopy were performed to alleviate the jaundice and to evaluate her biliary system. A diffuse-type tumor was detected in the common bile duct. The tumor had spread superficially up to the right anterior segmental duct and the left hepatic duct and involved the caudate branches. Curative surgery, which included a right anterior segmentectomy, total caudate lobectomy, and pylorus-preserving pancreatoduodenectomy, was performed. The histopathologic diagnosis was moderately differentiated tubular adenocarcinoma originating at the common bile duct. The extent of the superficial spread of the tumor corresponded to our preoperative determination. Her postoperative recovery was uneventful. In this case report, we discuss the accurate preoperative diagnosis and rational surgical treatment of bile duct carcinoma with superficial spread.
一名54岁女性因黄疸就诊。行经皮经肝胆道引流、通过经皮经肝胆道引流导管进行胆管造影以及经皮经肝胆道镜检查,以缓解黄疸并评估其胆道系统。在胆总管中检测到弥漫型肿瘤。肿瘤已浅表扩散至右前叶段胆管和左肝管,并累及尾状叶分支。进行了根治性手术,包括右前叶切除术、全尾状叶切除术和保留幽门的胰十二指肠切除术。组织病理学诊断为起源于胆总管的中分化管状腺癌。肿瘤的浅表扩散范围与我们术前的判断相符。她术后恢复顺利。在本病例报告中,我们讨论了具有浅表扩散的胆管癌的准确术前诊断和合理手术治疗。