肝门部胆管梗阻的病因分析——附80例报告

Etiological Analysis of Obstruction of Hilar Bile Duct: Report of 80 Cases

复习1991年9月至1996年9月的5年病历资料,将其中80例手术证实、以肝门部胆管梗阻为主要临床表现的病历进行了分析。结果:80例病人中,恶性梗阻57例,占63.8％;良性梗阻29例,占36.2％。恶性梗阻主要包括肝门部胆管癌、胆囊癌、肝癌、肝门部转移癌,以肝门部胆管癌最为常见。良性梗阻主要包括Mirizzi综合征、肝门部结石及其他。结论:肝门部胆管梗阻临床上主要表现为黄疸、肝内胆管扩张,应引起高度警惕,防止漏诊,但另一方面有些其他疾病也可造成肝门部胆管阻塞,临床上出现与胆管癌的类似病症,易误诊为胆管癌,也应仔细分析,才能得出正确的诊断。

Aims:From Sep. 1991 to Sep. 1996, 80 patients with obstruction of hilar bile duct confirmed surgically were retrospectively analysed. Results: Among the 80 cases, there were 57 cases(63.8%) of malignant obstruction and 29 cases(36.2) of benign obstruction. In malignant obstruction, there were hilar cholangiocarcinoma which is commonly affected, carcinoma of gallbladder, carcinoma of liver and hilar metastase; in benign obstruction included Mirizzi syndrome, calcul of hilar bile duct etc. Conclusions: The main features of obstruction of hilar bile duct are jaundice, and dilatation of intrahepatic bile duct which must pay great attention to avoid the misdiagnosis, because on the contrary, other diseases also may cause the obstruction of hilar bile duct. The definite diagnosis could be made by meticulous analysis.