肝胆管囊腺瘤16例诊治分析及文献复习

发布时间：2018-03-15 23:03

本文选题：囊腺瘤　切入点：胆管　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨肝胆管囊腺瘤的诊断和治疗方法,提高对本病的认识。方法回顾性分析2007年1月至2017年1月山东大学齐鲁医院普外科收治的16例病理诊断为肝胆管囊腺瘤患者的临床资料。结果16例肝胆管囊腺瘤患者含15例女性,1例男性,男女比例1:15,年龄51.7±13.2岁(25~69岁),主要临床表现为上腹部疼痛或不适。14例患者术前肝功能检查处于正常范围。15例患者行血清学肿瘤指标糖链抗原(CA)19-9检查,其中6例偏高,其他肿瘤指标,如甲胎蛋白(AFP)、癌胚抗原(CEA),均在正常范围内。只有1例患者合并乙肝病毒(HBV)感染。影像学显示肿瘤病灶5例位于肝右叶,7例位于肝左叶,2例位于左右叶交界处,2例位于胆总管。4例术前影像学诊断与术后病理学结果相符。15例患者行手术切除治疗(其中14例行根治性肝切除术,1例行肝囊肿开窗术),1例行经皮肝穿刺活检+微波热疗术,该例患者3年内复发。术后组织病理学结果显示肝胆管囊腺瘤14例,肝胆管囊腺瘤伴局部恶变2例。结论肝胆管囊腺瘤好发于中年女性,肝左叶多见,临床表现多无特异性,肝功能及肿瘤指标多位于止常范围,术前确诊较困难,误诊率高,需与其他肝囊性病变相鉴别,影像学检查有助于术前评估。根治性肝切除术为首选治疗方法,预后良好。
[Abstract]:Objective to investigate the diagnosis and treatment of hepatobiliary cystadenoma. Methods the clinical data of 16 cases of hepatobiliary cystadenoma diagnosed by pathology from January 2007 to January 2017 in general surgery of Qilu Hospital of Shandong University were analyzed retrospectively. Results 16 cases of hepatobiliary cystadenoma were diagnosed as hepatobiliary cystadenoma. The patient included 15 women and 1 male. The ratio of male to female was 1: 15, the age was 51.7 卤13.2 years old and 2569 years old. The main clinical manifestations were epigastric pain or discomfort. The liver function of 14 patients was in normal range before operation. Other tumor markers, Only one patient with hepatitis B virus hepatitis B virus (HBV) infection. Imaging showed that 5 cases were located in the right lobe of liver, 7 cases were located in the right lobe of the liver, 2 cases were located at the junction of the left and right lobes of the liver, 2 cases were located at the junction of the left and right lobes. The preoperative imaging diagnosis of 4 cases of choledochus was consistent with the pathological results after operation. 15 cases were treated by surgical resection (14 cases of radical hepatectomy and 1 case of fenestration of hepatic cyst) and 1 case of microwave hyperthermia of percutaneous biopsy of liver. The postoperative histopathological results showed that 14 cases of hepatic bile duct cystadenoma and 2 cases of hepatobiliary cystadenoma with local malignancy. Conclusion Hepatobiliary cystadenoma is more common in middle-aged women, liver Zuo Ye is more common, and the clinical manifestations are nonspecific. Most of liver function and tumor index are located in the normal range, the diagnosis is difficult before operation, the misdiagnosis rate is high, need to differentiate from other hepatic cystic disease, the imaging examination is helpful to evaluate before operation. Radical hepatectomy is the first treatment method, and the prognosis is good.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.8

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