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目的探讨肝内胆管结石与周围型肝内胆管细胞癌发生的关系及诊治措施。方法回顾性分析24例肝内胆管结石并发周围型肝内胆管细胞癌患者的临床资料。结果肝内胆管结石合并胆管细胞癌时,癌肿均发生于含结石胆管处;术前影像学诊断确诊率不高,B超、CT和MRI/MPCP对肝内胆管结石并发肝占位病变诊断率分别为40.9%(9/22)、53.8%(7/13)和66.7%(4/6);本组根治性切除率较低,总体预后较差,手术切除和肿瘤分化是影响预后重要因素。结论长期肝内胆管结石反复发作是引起胆管癌发生的重要原因;重视结石型肝胆管癌临床延误诊断的原因并采取相应的避免措施有助于早期诊断及提高预后。
Objective To investigate the relationship between the intrahepatic bile duct stones and the occurrence of intrahepatic cholangiocarcinoma and its diagnosis and treatment. Methods The clinical data of 24 patients with intrahepatic cholangiocarcinoma complicated by intrahepatic bile duct stones were analyzed retrospectively. Results Intrahepatic bile duct stones combined with cholangiocarcinoma occurred when the tumors were located in the biliary duct with lithiasis. The preoperative diagnosis of imaging diagnosis was not high. B-ultrasound, CT and MRI / MPCP were used to diagnose intrahepatic biliary calculi complicated with liver mass lesions The rates were 40.9% (9/22), 53.8% (7/13) and 66.7% (4/6) respectively. The radical resection rate in this group was low and the overall prognosis was poor. Surgical resection and tumor differentiation were important prognostic factors factor. Conclusion The recurrent seizure of long-term intrahepatic bile duct stones is an important cause of cholangiocarcinoma. Paying attention to the causes of delayed diagnosis of stone-cholangiocarcinoma and taking corresponding measures are helpful to the early diagnosis and prognosis.