肝内胆管囊腺瘤再次手术临床分析

The diagnosis and treatment of Intrahepatic biliary cystadenoma reoperation

目的探讨肝内胆管囊腺瘤再次手术的诊治特点。方法回顾性分析总结我院4例肝内胆管囊腺瘤根治性切除术后再次手术的诊治特点。结果肝内胆管囊腺瘤再次手术2例腹胀2例无明显症状,B超、CT、MRI可发现肝内占位难以确诊,再次手术均行根治性切除术,术后病理提示:囊腺瘤复发1例,囊腺癌1例,原发性肝癌1例,肝恶性纤维细胞瘤1例,术后均无明显并发症,随访2例死亡,生存时间为7个月与21个月,1例囊腺瘤痊愈至今未复发,1例肝内胆管囊腺癌随访18个月健在。结论肝内胆管囊腺瘤术后再发肝占位性质难以术前确诊,首选手术治疗,严格术前评估能够获得较好的治疗效果。

Objective To explore the diagnosis and treatment of intrahepatic biliary cystadenomareoperation. Methods We retrospectively analyze the clinical characteristics of reoperation after radical resection from 4 cases of intrahepatic biliary cystadenoma. Results Two with the clinical symptoms of abdominal pain and distension and two are asymptom, B ultrasonic CT MRI were used to diagnose but difficult to make a definite diagnosis;the pathological diagnosis with radical excision are reappearcystadenocarcinomapri- mary hepatic carcinoma and hepatic malignant fibrous histiotoma, the follow up time with two death are 7 and 21 months, one is alive wihout recurent and one is 18 months with cystadenocarcinoma. Conclution The focal liver lesions of Intrahepatic cystadenoma postoperation is hard to diagnosis, generally,we prefer to surgical treatment,and we can get a idea result with a strict preoperative assessment.