专题研究(Monographic Study)

肝胆管囊腺瘤临床诊治:附151例文献分析

Published at: 2016年第25卷第2期

王海涛 1 , 王锦波 2
1 新乡医学院 肝胆外科,河南 新乡 453000
2 中国人民解放军第三七一中心医院 肝胆外科,河南 新乡 453000
通讯作者 锦波 王 Email: dr-wang371@sohu.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.02.004
基金:

摘要

目的:探讨肝胆管囊腺瘤(IBCA)临床特点,为临床诊断与治疗提供参考。方法:收集15年来发表的关于IBCA临床文章,共计151例患者,对患者的诊断、治疗方法及预后等进行分析。结果:151例IBCA患者中81例术前被误诊,误诊率达53.6%,其中23例个案报告的误诊率为91.3%;患者平均年龄为49.5岁,女性明显多于男性(4.3:1),病程一般多在6年左右,发病部位左肝多于右肝(1.4:1);早期影像学检查和实验室检查特异性不强;手术全切后随访多数预后良好,有部分癌变。结论:IBCA临床表现无特异性,术前容易误诊,术中快速病理切片尤为必要,手术切除为主要治疗方法;IBCA有恶变倾向,术中尽量行肿瘤全切。


Diagnosis and treatment of intrahepatic biliary cystadenoma: a literature review of 151 cases

Abstract

Objective: To investigate the clinical features of intrahepatic biliary cystadenoma (IBCA), so as to provide reference for clinical use. Methods: The clinical articles concerning IBCA published over 15 years involving a total of 151 patients were collected, and diagnosis, treatment methods and outcomes of the patients were analyzed. Results: Of the 151 IBCA patients, 81 cases had preoperative misdiagnosis, so the misdiagnostic rate was 53.6%, which in the 23 reports of single case reached 91.3%. Of the patients, the average age was 49.5 years, number of females was higher than that of males (4.3:1), the general disease course was around 6 years, and the lesion was more frequently seen in the left liver than that in right liver (1.4:1). Both the imaging examinations and laboratory tests had less specificity in the early stage. After complete tumor resection, most cases had better outcomes and few cases had malignant transformation during follow-up. Conclusion: IBCA has no specific clinical manifestations, with high preoperative misdiagnostic rate, and intraoperative rapid frozen section procedure is important. Surgical resection is the main method of treatment. IBCA has a tendency to become malignant, so if possible, total resection of IBCA should be performed.


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引用

引用本文: 海涛 王, 锦波 王. 肝胆管囊腺瘤临床诊治:附151例文献分析 [J]. 中国普通外科杂志, 2016, 25(2): 181-185.
Cite this article as: WANG Haitao, WANG Jinbo . Diagnosis and treatment of intrahepatic biliary cystadenoma: a literature review of 151 cases[J]. Chin J Gen Surg, 2016, 25(2): 181-185.