伴胆道癌栓及引起梗阻性黄疸的原发性肝癌10例分析

Primary hepatic carcinoma complicated with obstructive jaundice caused by cancer embolus in biliary tract.

作者介绍过去7年间手术治疗原发性肝癌并发胆管内癌栓及胆囊内癌栓及致梗阻性黄痘者10例。该类型肝癌诊断困难,尤其肝脏无肿块者常被误诊成胆管癌、壶腹周围癌或胆石病。文中讨论了该型肝癌的发生率、发生机制、诊断难度与诊断方法及手术治疗问题。该型肝癌预后差,但姑息性手术,摘除胆管内癌栓、疏通胆道、减轻黄疸可延长病人生存时间。

From September 1988 to July 1995, 144 cases of primary hepatic carcinoma (PHC) were operated. Among these cases 10 cases of PHC with cancer embolus in biliary tract (9 cases in bile ducts and 1 case in cholecyst) were found. Of these 10 cases 6 presented obstructive jaundice caused by cancer emboli in bile ducts. The diagnosis of this type of PHC is difficult. It was misdiagnosed as cholangiocarcinoma, peri- ampullary carcinoma or cholelithiasis usually,especially when no tumor was found in the liver. In this paper, we discussed the mechanism of production of cancer embolus in biliary tract, diagnostic method and treatment of this type of PHC. The prognosis of this disease is poor because the resectability of primary tumor of liver is lower, but it may relieve the jaundice and prolong the survival period more or less by palliative operation with extirpation of cancer emboli from bile duct and with internal or external biliary drainage simultaneously.