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本文报告14例肝外胆管癌,占肝外胆道手术病例的1.6％。其中胆管上段癌4例,中段癌8癌,下段癌1例,广泛性胆管癌1例。大体呈乳头或息肉状型6例,结节型3例,扁平或溃疡型5例。组织学形态为乳头状腺癌6例,管状腺癌5例,低分化腺癌2例,粘液腺癌1例。癌旁胆管上皮呈乳头状增生5例,腺瘤样增生2例,同时可见不典型增生到癌的移行过渡。胆管结石,胆管炎,胆管腺瘤是引起胆管癌的重要诱发因素。
This article reports 14 cases of extrahepatic cholangiocarcinoma, accounting for 1.6% of cases of extrahepatic biliary surgery. There were 4 cases of upper bile duct carcinoma, 8 cases of middle carcinoma, 1 case of lower carcinoma, and 1 case of extensive bile duct carcinoma. There were 6 cases of papillary or polypoid type, 3 cases of nodular type, 5 cases of flat or ulcer type. The histological morphology was papillary adenocarcinoma in 6 cases, tubular adenocarcinoma in 5 cases, poorly differentiated adenocarcinoma in 2 cases, and mucinous adenocarcinoma in 1 case. Paraneoplastic bile duct epithelium showed papillary hyperplasia in 5 cases, adenomatous hyperplasia in 2 cases, and the transition from dysplasia to carcinoma was observed. Bile duct stones, cholangitis, and bile duct adenomas are important triggering factors for cholangiocarcinoma.