肝内胆管细胞癌合并肝门巨大淋巴结转移一例

Intrahepatic Cholangiocarcinoma with Huge Hilar Hepatic Lymph Node Metastasis: A Case Report

摘要: 目的：明确肝内胆管细胞癌合并淋巴结转移的患者行淋巴结清扫术的安全性以及可能获益。方法：分析1例原发性肝内胆管细胞癌合并巨大的肝门部淋巴结转移的中老年男性患者的临床表现、影像学表现、手术情况、术后并发症以及随访情况。结果：此例患者手术时间为315分钟，术中出血500 ml，术后住院时间8天，无术后主要并发症，该患者病理为中–低分化胆管细胞癌，肿瘤大小5 × 3.5 × 3 cm，8、12、13组淋巴结转移癌并融合肿块，目前随访8个月未见肿瘤复发。结论：肝内胆管细胞癌合并淋巴结转移的患者行淋巴结清扫术，手术风险可控，可能延长患者的无病生存期。

Abstract: Objective: To determine the safety and potential benefit of lymph node dissection in patients with intrahepatic cholangiocellular carcinoma with lymph node metastasis. Methods: A case of primary intrahepatic cholangiocarcinoma with large hilar lymph node metastasis was analyzed, including the clinical manifestations, imaging manifestations, surgical status, postoperative complications and follow-up. Results: The operation time of this patient was 315 minutes, the intraoperative hemorrhage was 500 ml, the postoperative hospital stay was 8 days, and no major postoperative complications were observed. The patient was pathologically identified as moderately to poorly differentiated cholangiocarcinoma with tumor size of 5 × 3.5 × 3 cm, lymph node metastasis and mass fusion in group 8, 12, and 13, and no tumor recurrence was observed during 8 months of follow-up. Conclusion: Lymph node dissection in patients with intrahepatic cholangiocellular carcinoma with lymph node metastasis can control the risk of operation and may prolong the disease-free survival of patients.