胆管腺瘤临床分析11例

A clinical analysis of 11 cases of bile duct adenoma

目的:探讨胆管腺瘤的临床病理特点及诊断治疗方法.方法:对我院经病理证实的11例胆管腺瘤的临床资料进行回顾性分析.结果:11例胆管腺瘤患者有9例女性,2例男性,平均年龄62.2岁.主要临床表现为腹痛、黄疸、发热.术前确诊困难,必须依靠病理组织学检查,恶变率高,肿瘤根治性切除是主要的治疗方法.所有患者均经病理证实为胆管腺瘤,其中乳头状腺瘤8例,管状乳头状腺瘤3例.其中6例伴有癌变,4例伴有不同程度的不典型增生.11例患者中,1例患者行活检术,10例患者行肿瘤根治性切除术.所有患者随访期间均未见明显复发迹象.结论:胆管腺瘤可广泛累及胆道系统,术前诊断较困难,恶变率高,易被误诊,确诊必须依靠病理组织学检查,肿瘤根治性切除是有效治疗方法,预后较好.

AIM： To investigate the clinicopathologic features, diagnosis and treatment of bile duct adenoma. METHODS： The clinical data for 11 patients with pathologically confirmed bile duct adenoma at our hospital were retrospectively analyzed. RESULTS： This group of patients included 9 females and 2 males. Their age ranged from 25 to 75 years, with an average of 62.2 years. Abdominal pain, jaundice and fever were main clinical manifestations. Diagnosis must rely on histopathological examination. Radical resection of the tumor is the most important treatment owing to the high incidence of malignant transformation. Eight patients had papillary adenoma, and 3 had tubule-papillary adenoma. Six cases were associated with cancer, and four cases had vary- ing degrees of dysplasia. One patient underwent biopsy, and 10 patients underwent radical tumor resection. All patients showed no obvious signs of recurrence throughout the follow-up period. CONCLUSION： Bile duct adenoma has a high incidence of malignant transformation. It is difficult to diagnose before surgery and is easily misdiagnosed. Diagnosis must rely on histopathological examination. Surgical resection is an effective way to treat the disease with a good prognosis.