: Hamartomas of the bile duct (von Meyenburg complex) are benign neoplasms of the liver, constituted histologically cystic dilatations of the bile duct, encompassed by fibrous stroma. We report a 42-year-old female pa...: Hamartomas of the bile duct (von Meyenburg complex) are benign neoplasms of the liver, constituted histologically cystic dilatations of the bile duct, encompassed by fibrous stroma. We report a 42-year-old female patient with symptomatic cholecystitis, whose gross and ultrasonic appearance suggestive of multiple liver metastases. Magnetic resonance imaging and liver biopsy are the gold standards for diagnosis of this rare hepatobiliary condition.展开更多
目的总结复杂肾囊肿行腹腔镜肾部分切除术的临床经验。方法回顾性分析2017年10月至2018年12月在北京协和医院诊治的复杂肾囊肿19例,其中男7例,女12例,平均年龄43.3岁(28～59岁);肾中部9例、肾上极4例和肾下极6例。囊肿平均直径3.32 cm (...目的总结复杂肾囊肿行腹腔镜肾部分切除术的临床经验。方法回顾性分析2017年10月至2018年12月在北京协和医院诊治的复杂肾囊肿19例,其中男7例,女12例,平均年龄43.3岁(28～59岁);肾中部9例、肾上极4例和肾下极6例。囊肿平均直径3.32 cm (2.5～5.1 cm)。Bosniak分型的情况:Ⅱ型6例、ⅡF型7例、Ⅲ型4例和Ⅳ型2例。结果本组19例患者均行腹腔镜肾部分切除术顺利。平均手术时间为(76.0±22.4) min (60～130 min),术中平均出血量为(38.0±35.5)mL(20～100 mL),肾动脉阻断时间平均为(17.0±10.2)min (14～28 min)。手术前后血清肌酐数值对比,无明显变化。术后病理组织学结果:肾透明细胞癌18例、单纯肾囊肿1例,病理切缘均阴性。结论腹腔镜肾部分切除术可以完整切除复杂肾囊肿,无论病理结果为良性与恶性,均可以达到治疗目的,可以避免第1次手术囊液种植转移和第2次手术切除肾脏,从而减少手术并发症和医疗隐患。展开更多
Hepatic cysts(HCs)are frequently discovered incidentally on abdominal imaging.The prevalence of HCs has been reported as high as 15–18%in the United States.Although most cysts are benign,some are malignant or premali...Hepatic cysts(HCs)are frequently discovered incidentally on abdominal imaging.The prevalence of HCs has been reported as high as 15–18%in the United States.Although most cysts are benign,some are malignant or premalignant.It is impor-tant to diagnose cystic lesions in order to properly manage them.Imaging with conventional ultrasound,computed to-mography,magnetic resonance imaging,or contrast-enhanced ultrasound can be used to further characterize and diagnose HCs.Ultrasound is typically the first-line imaging modality,whereas more advanced imaging can help narrow down the specific lesion.Contrast-enhanced ultrasound is a newer mo-dality,recently approved in the United States,which offers non-invasive evaluation in real-time.The first step in diagnosis is stratifying risk by differentiating simple and complex cysts.There are several features that can help identify HCs,including septae,mural consistency,calcifications,and quality of cystic fluid.Simple cysts are mainly congenital cysts,but also occur in polycystic liver disease.Complex cysts include mucinous neoplasms,echinococcal cysts,hemorrhagic cysts,cystic hep-atocellular carcinoma and other rare lesions.Treatment is indicated in symptomatic cysts or those suspicious for malig-nant or premalignant features.Treatment modalities include fenestration,aspiration sclerotherapy,or surgical resection.展开更多
文摘: Hamartomas of the bile duct (von Meyenburg complex) are benign neoplasms of the liver, constituted histologically cystic dilatations of the bile duct, encompassed by fibrous stroma. We report a 42-year-old female patient with symptomatic cholecystitis, whose gross and ultrasonic appearance suggestive of multiple liver metastases. Magnetic resonance imaging and liver biopsy are the gold standards for diagnosis of this rare hepatobiliary condition.
文摘目的总结复杂肾囊肿行腹腔镜肾部分切除术的临床经验。方法回顾性分析2017年10月至2018年12月在北京协和医院诊治的复杂肾囊肿19例,其中男7例,女12例,平均年龄43.3岁(28～59岁);肾中部9例、肾上极4例和肾下极6例。囊肿平均直径3.32 cm (2.5～5.1 cm)。Bosniak分型的情况:Ⅱ型6例、ⅡF型7例、Ⅲ型4例和Ⅳ型2例。结果本组19例患者均行腹腔镜肾部分切除术顺利。平均手术时间为(76.0±22.4) min (60～130 min),术中平均出血量为(38.0±35.5)mL(20～100 mL),肾动脉阻断时间平均为(17.0±10.2)min (14～28 min)。手术前后血清肌酐数值对比,无明显变化。术后病理组织学结果:肾透明细胞癌18例、单纯肾囊肿1例,病理切缘均阴性。结论腹腔镜肾部分切除术可以完整切除复杂肾囊肿,无论病理结果为良性与恶性,均可以达到治疗目的,可以避免第1次手术囊液种植转移和第2次手术切除肾脏,从而减少手术并发症和医疗隐患。
文摘Hepatic cysts(HCs)are frequently discovered incidentally on abdominal imaging.The prevalence of HCs has been reported as high as 15–18%in the United States.Although most cysts are benign,some are malignant or premalignant.It is impor-tant to diagnose cystic lesions in order to properly manage them.Imaging with conventional ultrasound,computed to-mography,magnetic resonance imaging,or contrast-enhanced ultrasound can be used to further characterize and diagnose HCs.Ultrasound is typically the first-line imaging modality,whereas more advanced imaging can help narrow down the specific lesion.Contrast-enhanced ultrasound is a newer mo-dality,recently approved in the United States,which offers non-invasive evaluation in real-time.The first step in diagnosis is stratifying risk by differentiating simple and complex cysts.There are several features that can help identify HCs,including septae,mural consistency,calcifications,and quality of cystic fluid.Simple cysts are mainly congenital cysts,but also occur in polycystic liver disease.Complex cysts include mucinous neoplasms,echinococcal cysts,hemorrhagic cysts,cystic hep-atocellular carcinoma and other rare lesions.Treatment is indicated in symptomatic cysts or those suspicious for malig-nant or premalignant features.Treatment modalities include fenestration,aspiration sclerotherapy,or surgical resection.
