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目的探讨肝内胆管囊腺瘤的诊断和治疗。方法回顾性分析2003年1月至2009年12月中国医科大学附属盛京医院收治的17例肝内胆管囊腺瘤病人的临床资料。结果主要临床表现为上腹部不适或疼痛。2例曾误诊为肝囊肿行开窗引流术。6例病人CA19-9升高,1例甲胎蛋白(AFP)轻度升高,癌胚抗原(CEA)水平均正常。7例术前影像学检查确诊。均行根治性肝切除手术。病理结果显示肝内胆管囊腺瘤14例,胆管囊腺瘤恶变3例。术后随访8~60个月无复发。结论肝内胆管囊腺瘤术前难以确诊,易恶变,根治性肝切除手术疗效满意。
Objective To investigate the diagnosis and treatment of intrahepatic cholangiocarcinoma. Methods The clinical data of 17 patients with intrahepatic cholangiocarcinoma admitted from Shengjing Hospital affiliated to China Medical University from January 2003 to December 2009 were retrospectively analyzed. The main clinical manifestations of upper abdominal discomfort or pain. 2 cases had been misdiagnosed as hepatic cysts open fenestration. 6 cases of patients with elevated CA19-9, 1 case of AFP slightly increased, carcinoembryonic antigen (CEA) levels were normal. 7 cases were diagnosed by preoperative imaging examination. All underwent radical liver resection surgery. Pathological findings showed intrahepatic biliary cystadenoma in 14 cases, bile duct cystadenoma in 3 cases. No follow-up of 8 to 60 months follow-up. Conclusions intrahepatic biliary cystadenoma is difficult to diagnose before operation, it is easy to malignant transformation, and the effect of radical hepatectomy is satisfactory.