论文部分内容阅读
目的探讨继发于肝内胆管结石的肝胆系统恶性肿瘤的发病率、临床特点和预防方法。方法对合并肝内胆管结石的肝胆恶性肿瘤患者进行临床回顾性研究。结果自 1996～ 2 0 0 0年连续收治 5 5 6例肝内胆管结石患者 ,其中 2 7例合并存在肝胆系统恶性肿瘤 ,其平均发病率为 4 8%。本组术前明确诊断仅 4例。肝内胆管结石继发恶性肿瘤的临床表现包括非典型肝脓肿、难以控制的感染、不明原因的进行性黄疸、CT和B超检查中可疑的肿瘤性改变和腹部肿块。本组患者以中晚期病例为主 ,仅 3例患者作了肿瘤切除术。结论肝内胆管结石继发恶性肿瘤的概率较高 ,切除结石所在的病灶肝段可能对继发的恶性肿瘤有预防作用
Objective To investigate the incidence, clinical features and prevention of hepatobiliary malignant tumor secondary to intrahepatic bile duct stones. Methods Clinical retrospective studies were performed on patients with hepato-biliary malignancies complicated with intrahepatic bile duct stones. Results From 1996 to 2000, 556 patients with intrahepatic bile duct stones were consecutively treated, of which 27 cases had hepato-biliary system malignant tumors. The average incidence rate was 48%. In this group, only 4 cases were diagnosed before surgery. The clinical manifestations of intrahepatic bile duct stones secondary to malignant tumors include atypical liver abscesses, uncontrolled infections, unexplained progressive jaundice, suspected neoplastic changes on CT and B-ultrasound, and abdominal masses. In this group of patients, mainly in the middle and late cases, only 3 patients underwent tumor resection. Conclusions The probability of secondary malignant tumors in intrahepatic bile duct stones is high, and the segment of the lesion where the stones are removed may have a preventive effect on secondary malignant tumors.