肝胆管结石合并肝胆管癌的临床分析

Clinical analysis of hepatolithiasis combined with intrahepatic cholangiocarcinoma

目的探讨肝胆管结石和肝胆管癌的关系以及肝胆管结石合并肝胆管癌的临床特点、诊断及治疗。方法回顾性分析6例肝胆管结石合并肝胆管癌患者的临床资料。结果 6例患者中,2例行内镜下逆行胆汁内引流及支架植入术,其余4例行开腹手术,其中3例行肝切除术。术后病理均提示为腺癌。结论肝胆管结石合并肝胆管癌的可能性大,临床医生应对长期肝胆管结石提高警惕,掌握肝胆管结石合并肝胆管癌的临床表现特征,重视对高危对象的定期复查。肝切除术是治疗肝胆管结石合并肝胆管癌的有效手段,一旦确诊,宜早期手术。

Objective To investigate the relationship between hepatolithiasis and intrahepatic cholangiocarcinoma,and to study the clinical features,diagnosis,treatment of hepatolithiasis combincd with intrahepatic cholangiocarcinoma.Methods 6 cases of hepatolithiasis associated with intrahepatic cholangiocarcinoma were analyzed retrospectively.Results Among 6 cases,2 cases were treated by endoscopic retrograde biliary drainage and stent implantation,4 cases were treated by laparotomy,in which 3 cases underwented hepatic resection.Pathological examination suggested that all cases were adenocarcinoma.Conclusion Hepatolithiasis is closely related with intrahepatic cholangiocarcinoma.Therefore,clinical doctors should be vigilant with the long-term hepatolithiasis,and pay attention to the clinical features of hepatolithiasis associated with intrahepatic cholangiocarcinoma and put more emphasis on the periodic review of high-risk patients.Liver resection is an effective means to treat hepatolithiasis associated with intrahepatic cholangiocarcinoma and should be operated as soon as possible when diagnosed.