Biliary Papillomatosis: A Case Report and Review of the Literature

膽道乳突狀瘤病是一種罕見之膽道良性癌前瘤病。本文報告一例個案並回顧相關文獻。患者為一69歲男性到院時主訴反覆發生上腹疼痛及發燒達四年之久。理學檢查發現右上腹部壓痛。實驗室檢驗只發現血液中有白血球減少及嗜中性球比例增多的現象，其餘一般生化檢驗及腫瘤指標等皆在正常值範圍內。患者接受腹部超音波，腹部電腦斷層及逆行性膽道攝影等一系列影像檢查後發現肝外膽管有明顯擴大及多發性腫瘤存在的情形。患者接受肝左葉切除，根除性總膽管切除，膽囊切除及肝門空腸吻合手術治療。術後患者恢復順利，無肝衰竭或膽管空腸吻合漏等併發症。術後追蹤至今16個月並無膽管炎或腫瘤復發等情形發生。臨床上膽道乳突狀瘤病常導致復發性膽管炎及黃膽，並有惡性變化為膽管癌之可能性，故治療上應以根除性手術切除為主，切除所有含有病兆之肝葉及膽管。

關鍵字

膽道乳突狀瘤病；膽石病；肝門空腸吻合術；癌前的

並列摘要

Biliary papillomatosis (BP) is a rare precancerous neoplastic disease of the intra- and extrahepatic bile ducts. A 69-year-old male visited the hospital with chief complaints of repeated episodes of fever and upper abdominal pain for 4 years. Physical examination revealed tenderness over the right upper quadrant of the abdomen. Laboratory studies including blood count, and biochemical and tumor markers showed leukopenia with neutrophilia only. A series of studies, including ultrasound, computed tomography, and endoscopic retrograde cholangiography, revealed dilated extrahepatic ducts with multiple soft-tissue-mass densities. A left hepatectomy, cholecystectomy, radical resection of the common bile duct, and Roux-en-Y hepaticojejunostomy were performed. The postoperative course was smooth without hepatic decompensation or anastomotic leakage. No recurrences of the cholangitis or tumors were found during the past 16 months. Since BP is considered a precancerous disease and can result in repeated cholangitis and obstructive jaundice, curative resection of the involved liver and biliary trees should be the treatment of choice.

並列關鍵字

biliary papillomatosis ； cholelithiasis ； hepaticojejunostomy ； precancerous

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Biliary Papillomatosis: A Case Report and Review of the Literature

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