本文選題：囊腺瘤　切入點(diǎn)：膽管　出處：《山東大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討肝膽管囊腺瘤的診斷和治療方法,提高對本病的認(rèn)識。方法回顧性分析2007年1月至2017年1月山東大學(xué)齊魯醫(yī)院普外科收治的16例病理診斷為肝膽管囊腺瘤患者的臨床資料。結(jié)果16例肝膽管囊腺瘤患者含15例女性,1例男性,男女比例1:15,年齡51.7±13.2歲(25~69歲),主要臨床表現(xiàn)為上腹部疼痛或不適。14例患者術(shù)前肝功能檢查處于正常范圍。15例患者行血清學(xué)腫瘤指標(biāo)糖鏈抗原(CA)19-9檢查,其中6例偏高,其他腫瘤指標(biāo),如甲胎蛋白(AFP)、癌胚抗原(CEA),均在正常范圍內(nèi)。只有1例患者合并乙肝病毒(HBV)感染。影像學(xué)顯示腫瘤病灶5例位于肝右葉,7例位于肝左葉,2例位于左右葉交界處,2例位于膽總管。4例術(shù)前影像學(xué)診斷與術(shù)后病理學(xué)結(jié)果相符。15例患者行手術(shù)切除治療(其中14例行根治性肝切除術(shù),1例行肝囊腫開窗術(shù)),1例行經(jīng)皮肝穿刺活檢+微波熱療術(shù),該例患者3年內(nèi)復(fù)發(fā)。術(shù)后組織病理學(xué)結(jié)果顯示肝膽管囊腺瘤14例,肝膽管囊腺瘤伴局部惡變2例。結(jié)論肝膽管囊腺瘤好發(fā)于中年女性,肝左葉多見,臨床表現(xiàn)多無特異性,肝功能及腫瘤指標(biāo)多位于止常范圍,術(shù)前確診較困難,誤診率高,需與其他肝囊性病變相鑒別,影像學(xué)檢查有助于術(shù)前評估。根治性肝切除術(shù)為首選治療方法,預(yù)后良好。
[Abstract]:Objective to investigate the diagnosis and treatment of hepatobiliary cystadenoma. Methods the clinical data of 16 cases of hepatobiliary cystadenoma diagnosed by pathology from January 2007 to January 2017 in general surgery of Qilu Hospital of Shandong University were analyzed retrospectively. Results 16 cases of hepatobiliary cystadenoma were diagnosed as hepatobiliary cystadenoma. The patient included 15 women and 1 male. The ratio of male to female was 1: 15, the age was 51.7 鹵13.2 years old and 2569 years old. The main clinical manifestations were epigastric pain or discomfort. The liver function of 14 patients was in normal range before operation. Other tumor markers, Only one patient with hepatitis B virus hepatitis B virus (HBV) infection. Imaging showed that 5 cases were located in the right lobe of liver, 7 cases were located in the right lobe of the liver, 2 cases were located at the junction of the left and right lobes of the liver, 2 cases were located at the junction of the left and right lobes. The preoperative imaging diagnosis of 4 cases of choledochus was consistent with the pathological results after operation. 15 cases were treated by surgical resection (14 cases of radical hepatectomy and 1 case of fenestration of hepatic cyst) and 1 case of microwave hyperthermia of percutaneous biopsy of liver. The postoperative histopathological results showed that 14 cases of hepatic bile duct cystadenoma and 2 cases of hepatobiliary cystadenoma with local malignancy. Conclusion Hepatobiliary cystadenoma is more common in middle-aged women, liver Zuo Ye is more common, and the clinical manifestations are nonspecific. Most of liver function and tumor index are located in the normal range, the diagnosis is difficult before operation, the misdiagnosis rate is high, need to differentiate from other hepatic cystic disease, the imaging examination is helpful to evaluate before operation. Radical hepatectomy is the first treatment method, and the prognosis is good.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.8

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