| Objective: To review the clinical features, diagnosis approach, surgical treatment andprognosis of mucin-producing bile duct tumors (MPBTs). Methods: The clinical datafrom patients with histopathological diagnosis confirmed on operative specimens wereanalyzed retrospectively. Results: There were15patients with MPBTs in our hospitalfrom January2007to December2011. Patients were6males and9females, agedbetween44and69years. The most common presenting symptom was obstructivejaundice, abdominal discomfort, poor appetite, nausea, fever and chills. Nine patients hadhistories of hepatobiliary operation because hepatolithiasis. The carbohydrate antigen19-9(CA19-9) were positive in six cases (40%), the carcinoembryonic antigen (CEA)were all within normal limits except for slightly increased levels in three cases (20%),and the alpha-fetoprotein (AFP) were all negative. HCV infection was noted in onepatients (6.7%). All patients received preoperative ultrasound (US), computedtomography (CT) or Magnetic Resonance (MR), which described focal ductal dilatationor dilatation of both extra-and intrahepatic bile duct, some with lithiasis or a mass in thedilated bile ducts. Endoscopic retrograde cholangiopancreato-graphy (ERCP) can foundfilling defect in the common bile duct and take out a good deal of mucus.14cases wereresectable, including8cases were also given Roux-en-Y biliary-enteric anastomosis. Theunresectable case was given the exploration of the common bile duct plus T-tubedrainage. All15patients were recorded with clinically detectable a jelly-like substanceafter incision of the bile duct. In the dilated bile duct it shows papillary growth which isvisible. Histologically, it is a well-differentiated papillary adenocarcinoma which isinvasive or non-invasive. The median follow-up time after operation was18months(range1~61months),9cases survived and6died. Conclusions: Complete resection ofMPBTs based on accurate preoperative assessment of tumor, and made it possible toachieve long-term survival. |
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