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目的探讨肝内胆管囊腺瘤的临床表现、诊断和治疗方法。方法回顾性分析2004年1月至2013年12月期间笔者所在医院诊治的12例肝内胆管囊腺瘤患者的临床资料。结果女10例,男2例;平均年龄49.0岁(16~77岁);病程为1个月~3年,平均病程7个月。临床表现为右上腹饱胀感伴隐痛6例、右上腹肿块1例、黄疸1例,无症状体检发现4例。增强CT检查示肿瘤包膜完整、内有分隔者11例,分隔之间密度不一致;增强后内容物无强化,但囊壁及分隔可见轻度强化者9例。12例均行手术治疗,并完整切除肿瘤。仅有1例腺瘤恶变者于术后2年复发,另11例均无复发。结论肝内胆管囊腺瘤好发于中年女性,主要临床症状为上腹饱胀感伴隐痛、右上腹肿块、黄疸等;增强CT是其主要的术前诊断方法。手术完整切除肿物是最佳的治疗方案,可以有效防止其复发。
Objective To investigate the clinical manifestations, diagnosis and treatment of intrahepatic cholangiocarcinoma. Methods The clinical data of 12 patients with intrahepatic cholangiocarcinoma diagnosed and treated in our hospital from January 2004 to December 2013 were retrospectively analyzed. Results 10 females, 2 males; mean age 49.0 years (16 to 77 years); duration of 1 month to 3 years, with an average duration of 7 months. Clinical manifestations of the right upper quadrant femoral headache with 6 cases of pain, right upper quadrant mass in 1 case, jaundice in 1 case, asymptomatic physical examination found in 4 cases. Enhanced CT examination revealed a complete tumor capsule, there are 11 cases of dividers, the density is not consistent between the partitions; enhanced without enhancement of the contents, but the wall and separated by mild enhancement seen in 9 cases. All 12 cases underwent surgery, and complete resection of the tumor. Only 1 case of malignant adenoma relapsed 2 years after operation, and the other 11 cases had no recurrence. Conclusions Intrahepatic cholangiocarcinoma occurs in middle-aged women. The main clinical symptoms are abdominal pain, upper right abdomen mass, jaundice, etc .; CT is the main preoperative diagnosis. Complete removal of the tumor surgery is the best treatment, which can effectively prevent the recurrence.