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目的 总结原发性肝癌伴胆管癌栓的临床特征和治疗方法 ,分析误诊的原因。方法 对 14例原发性肝癌伴胆管癌栓进行回顾性分析。结果 全组 14例术前均未确诊为胆管癌栓引起梗阻性黄疸 ,误诊为胆管癌 4例、壶腹周围癌 1例、胆石症 4例。结论 原发性肝癌伴胆管癌栓误诊率高 ;肝脏原发癌灶较小或未发现原发癌灶 ,术前、术中均易发生误诊。提高对本病的认识是减少误诊的关键 ,AFP测定和术中病理冰冻切片检查有助确诊。
Objective To summarize the clinical features and treatment of primary hepatocellular carcinoma with cholangiocarcinoma and to analyze the causes of misdiagnosis. Methods 14 cases of primary hepatocellular carcinoma with cholangiocarcinoma were retrospectively analyzed. Results All 14 cases were diagnosed as cholangiocarcinoma without obstructive jaundice before operation, 4 cases were misdiagnosed as cholangiocarcinoma, 1 case was periampullary carcinoma and 4 cases were cholelithiasis. Conclusion The misdiagnosis rate of primary hepatocellular carcinoma with cholangiocarcinoma thrombus is high. Primary liver lesion is small or no primary tumor is found. Misdiagnosis is preoperatively and intraoperatively. To improve the understanding of this disease is to reduce the key to misdiagnosis, AFP determination and intraoperative pathological frozen biopsy can help diagnose.