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目的总结肝内胆管囊腺癌的诊断及治疗方法。方法回顾性分析笔者所在医院2000年4月至2013年7月期间收治的7例肝内胆管囊腺癌患者的临床资料。结果 7例患者均经实验室检查和影像学检查初步诊断为肝脏占位,但确诊依据的是术后病理学检查。5例行根治性手术切除,其中4例行半肝切除术(非浸润型),随访期间均存活,1例行囊壁完整切除术(浸润型)者于术后18个月死亡;1例行囊壁大部分切除术(浸润型),于术后12个月死亡;1例行彩超引导下的肝脏穿刺囊内积液引流、细针穿刺活检术(浸润型),于术后7个月死亡。结论肝内胆管囊腺癌的影像学表现多为肝脏囊性病变,但确诊仍需病理学检查。肝内胆管囊腺癌局限于囊内者,通过行完整切除即可获得较满意的临床疗效;而癌细胞向囊壁外肝组织浸润生长者的预后差,生存时间短。
Objective To summarize the diagnosis and treatment of intrahepatic cholangiocarcinoma. Methods The clinical data of 7 patients with intrahepatic cholangiocarcinoma admitted to our hospital from April 2000 to July 2013 were retrospectively analyzed. Results All the 7 patients were initially diagnosed as hepatic lesions by laboratory examination and imaging examination, but the diagnosis was based on postoperative pathological examination. Five cases underwent radical resection, of which 4 cases underwent semi-hepatectomy (non-invasive) and survived during follow-up. One case underwent complete resection of the cyst wall (infiltrative type) died at 18 months after operation. One case of balloon Most of the resection of the wall (infiltration type), 12 months after the death; 1 case under the guidance of color Doppler ultrasound drainage of liver puncture drainage, fine needle biopsy (infiltration), died after 7 months . Conclusions Intrahepatic cholangiocarcinoma of the cystadenocarcinoma imaging mostly cystic liver disease, but the diagnosis still need pathological examination. Intrahepatic biliary cystadenocarcinoma confined to the cysts, through the line of complete resection can be more satisfied with the clinical efficacy; and cancer cells to the outer wall of the cyst outside the liver tissue infiltration of poor prognosis, short survival time.