Carolis 病诊断与治疗(附39例报告)

Diagnosis and treatment of Carolis disease

目的探讨 Carolis 病的诊治临床经验。方法对39例 Carolis 病临床资料回顾分析。结果男11例、女28例,平均年龄38.5岁,其中全肝型16例,左半肝型18例,右半肝型5例。伴发胆管癌变21例,占53.8%;伴发肝胆管结石36例,占93.5%;伴发肝吸虫病11例,占29%,伴发肾囊肿26例,占67.7%;实施肝叶段切除术13例,左半肝切除、肝总管空肠吻合术13例,右半肝切除、肝总管空肠吻合术7例。结论 (1)切除扩张肝管在内的肝叶是 Carolis 病较理想的手术方式;(2)Carolis 病可视作癌前病变处理,全肝型是肝移植的适应证;(3)MRCP 是目前诊断 Carolis 病首选方法。

Objective To summarize experience in diagnosis and treatment of Carolis disease. Methods Clinical data of 39 patients with Carolis age disease treated in our hospital were retrospec- tively analyzed.Results Of the patients with an average of 38.5,11 were male and 28 female.The lesion was found in the whole liver in 16 patients,in the left lobe in 18 and in the right lobe in 5.The accompanying of cholangiocarcinoma in 21 cases(53.8%),that of cholelithiasis in 36(93.5%),that of heterophydiasis in 11(29%)and that of polyeystic kidney in 26(67.7%).Liver lobectomy was performed in 13 patients,the left liver lobectomy and hepatocholangioenterostomy in other 13 and the right liver lobectomy and hepatocholangioenterostomy in 7.Conclusions(1)It is a good operation for treatment of Carolis disease to remove the liver lobe including the dilated hepatic biliary tracts.(2) Carolis disease can be considered as the preneoplastic lesion.The whole-liver type Carolis disease is the indication for liver transplantation.(3)MRCP is of the first choice for diagnosis of Carolis disease nowadays.