胆囊结石漏诊壶腹部肿瘤5例分析

Analysis on Missed Diagnosis of Periampullary Tumor in Five Cases of Cholecystolithiasis

目的 探讨胆囊结石合并壶腹部肿瘤的诊断、治疗. 方法 回顾分析我院1994年5月～2006年3月2680例腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）中5例胆囊结石合并壶腹部肿瘤的临床资料. 结果 5例LC术后0.5～17个月出现上腹部疼痛、巩膜、皮肤黄染等症状和体征,再次入院检查发现壶腹部肿块,诊断为壶腹部肿瘤,系第1次手术时漏诊壶腹部肿瘤. 结论 提高对胆囊结石合并壶腹部肿瘤的认识,联合开展多种辅助检查,加强术后随访等有利于避免对壶腹部肿瘤的漏诊和早期诊断治疗.

Objective To explore the diagnosis and treatment of cholecystolithiasis accompanying periampullary tumor. Methods A retrospective analysis was performed with clinical data of 5 patients with cholecystolithiasis complicated with periampullary tumor among the 2680 patients receiving laparoscopic cholecystectomy （LC） in our hospital from May 1994 to March 2006. Results Pain in epigastrium, icteric sclera and skin were found in all 5 patients 0.5 - 17 months after LC. Neoplasms in ampulla were found in re-hospitalization, and periampullary tumor was diagnosed, which were missed in the first operation. Conclusions Improving the knowledge of cholecystolithiasis complicated with periampullary tumor, performing various auxiliary investigations, and reinforcing postoperative follow-up are beneficial for avoidance of missed diagnosis of periampullary tumor, and for early diagnosis and treatment.