肝外胆管腺瘤30例临床诊治分析

Analysis of the diagnosis and treatment of extrahepatic bile duct adenoma: a report of 30 cases

目的探讨肝外胆管腺瘤的临床特点及诊疗方法,提高对该疾病的认识。方法回顾性分析中国医科大学附属盛京医院2010年1月至2017年12月间收治的30例肝外胆管腺瘤临床资料。结果 30例肝外胆管腺瘤患者中女17例,男13例,年龄(58.2±12.2)岁,主要表现为黄疸、上腹部疼痛、发热及体质量减轻等症状。所有患者均行手术治疗,术后均经病理检查确诊。随访0.25～100个月,失访7例,死亡5例,其中2例死于术后感染,3例死于术后复发转移;另外18例患者未见复发。结论肝外胆管腺瘤属于罕见的肝外胆管肿瘤,好发于中老年人,术前诊断困难、易恶变,根治性切除是其主要治疗方法,术后亦有复发可能应定期复查。

Objective：To study the clinical characteristics, diagnosis and treatment of extrahepatic bile duct adenoma. Methods：The clinical data of thirty cases of extrahepatic bile duct adenoma admitted between January 2010 and December 2017 in Shengjing Hospital of China Medical University were analyzed retrospectively. Results：Of the 30 patients, 17 were female and 13 were male, the age was （58.2±12.2） years old. The main clinical symptoms were jaundice, upper abdominal pain, fever and weight loss. All patients were treated with surgical procedure and confirmed by postoperative pathological examination. After a range from 0.25 to 100 months of follow-up, 7 patients lost control, 2 died of postoperative infection, 3 died of postoperative recurrence and metastasis, and 18 had no recurrence. Conclusions：Extrahepatic bile duct adenoma is a rare extrahepatic bile duct tumor, which is often found in middle and old people. It is difficult to diagnose before operation, and easy to develop adenocarcinoma. Radical resection is the main treatment method. The possibility of recurrence after operation should be reviewed regularly.