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在119例肝内结石患者中,经手术证实合并肝内胆管癌8例,发生率为4%;癌肿均发生于含石胆管处。肉眼病理为结节型(3例)、弥漫硬化型(3例)和肿块型(2例)。其中3例合并自发性胆汁外瘘,这可能为含石性胆管癌特有的临床现象。作者结合622例原发性肝癌中检出的13例肝内胆管癌及22例无癌性肝内结石患者的临床、病理学资料,讨论了肝内结石患者发生肝内胆管癌的病因、临床特点、诊断及延误诊断的原因。
In 119 patients with intrahepatic stones, 8 cases had intrahepatic cholangiocarcinoma confirmed by surgery. The incidence rate was 4%; all of the cancers occurred in the bile ducts containing stones. The gross pathology was nodular (3 cases), diffuse sclerosis (3 cases) and mass (2 cases). Three of these patients had spontaneous biliary fistulae, which may be a unique clinical phenomenon of lithoid bile duct cancer. The authors combined the clinical and pathological data of 622 cases of intrahepatic cholangiocarcinoma detected in 622 cases of primary liver cancer and 22 cases of non-cancerous intrahepatic stones, and discussed the causes and clinical conditions of intrahepatic cholangiocarcinoma in patients with intrahepatic stones. Characteristics, diagnosis, and reasons for delayed diagnosis.