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当黄疸病人行胆道造影发现肝总管有局部狭窄病变,可能为其他病因引起者,常会作出Klatskin肿瘤的初步诊断。由于从未有人作过验证,本文作者将98例术前诊断为Klatskin肿瘤的患者与其最后的组织学诊断进行比较,结果表明术前诊断是很不可靠的,而且在对患者的处理、尤其是非手术治疗方面可能导致严重错误。自1985年～1990年共收治因胆总管阻塞病变、由临床和放射学初诊为Klat skin肿瘤的患者98例(男48,女50),平均年龄64岁。经B超检查92例;CT扫描62例。全部行胆道造影,其中经皮肝穿刺胆道造影(pTC)85例;内窥镜逆行胰胆管造影(ERCP)71例;两者联合造影58例。为了充分显示肝内外胆管解剖结构,可行多处肝穿刺胆道造影。血管造影17例,用于了解肝动脉或门静脉受侵犯情况。Klatskin肿瘤的术前诊断主要依据为PTC证实位于或临近肝
When patients with jaundice underwent cholangiography and found that there were local stenotic lesions in the common hepatic duct, which may be caused by other etiologies, a preliminary diagnosis of Klatskin tumors was often made. Since no one has ever been verified, the authors compared 98 patients with Klatskin tumors preoperatively diagnosed with their final histological diagnosis. The results show that the preoperative diagnosis is very unreliable, and that the treatment of patients, especially non- Surgical treatment can lead to serious errors. From 1985 to 1990, a total of 98 patients (48 males and 50 females) with an initial clinical and radiological diagnosis of Klat skin tumors were admitted to the hospital due to obstruction of the common bile duct. The average age was 64 years. After B-ultrasound examination in 92 cases; CT scan in 62 cases. All patients underwent cholangiography, including 85 cases of percutaneous transhepatic cholangiography (pTC), 71 cases of endoscopic retrograde cholangiopancreatography (ERCP), and 58 cases of combined angiography. In order to fully display the intrahepatic and extrahepatic bile duct anatomy, multiple liver puncture cholangiography is feasible. Angiography in 17 cases was used to understand the hepatic artery or portal vein invasion. The preoperative diagnosis of Klatskin tumors is based on PTC confirmation of the presence or proximity of the liver