Diagnosis and treatment of mucinous tumor of the bile duct: our experience on 11 patients / 中华肝胆外科杂志

Objective To study the diagnosis,treatment and therapeutic results of 11 patients who suffered from mucinous tumor of the bile duct.Methods Eleven patients who were diagnosed to suffer from mucinous tumor of the bile duct were retrospectively studied.Three patients who presented with obstructive jaundice were diagnosed on ERCP,and 8 patients who had extra-and intrahepatic cholangiolithiasis were diagnosed by biopsy during choledochoscopy.Results One of the 3 patients who underwent ERCP died from obstructive jaundice after failed drainage of bile using endoscopic nasobiliary drainage (ENBD).The remaining two patients underwent laparoscopic common bile duct exploration and T tube drainage.The eight patients who had extra-and intrahepatic cholangiolithiasis were diagnosed by biopsy during choledochoscopy.Conclusions The clinical presentation of mucinous tumor of bile duct is non-specific and the preoperative misdiagnosis rate is high.Common bile duct exploration,T tube drainage and long-term T tube drainage is a good way to treat mucinous tumor of the bile duct.

Surgical strategies for type Ⅱ a hepatolithiasis / 中华肝胆外科杂志

The clinical data of 143 patients with type Ⅱ a hepatolithiasis with normal function of the sphincter of Oddi were analyzed.The patients were divided into two groups at random.The data of the 2 groups of patients were compared on the operating time,hospitalization,rates of complication,residual stone rates and recurrence rates.The A group patients underwent laparoscopic video choledochoscopic hepaticocholangiolithotomy,T-tube drainage and choledochoscopic lithotomy.The B group patients underwent laparoscopic video hepatectomy and choledochoscopic lithotomy.For most of the patients in the A group,the treatment had the advantages of less trauma,less complications and quicker recovery.There was no significant differences in residual stone rates and recurrence rates between the two groups.As it was difficult to remove stones in the caudate lobes of Ⅱ a type patients in A group due to the sharp angle between the hepatic duct and bile ducts of the caudate lobe,individualized programs should be adopted according to the location of stones on individual patients.