Analysis Of Diagnosis And Treatment Of Hepatolithiasis Associated With Intrahepatic Cholangiocarcinoma

Objective:Clinical data by the hepatolithiasis combined with intrahepatic cholangiocarcinoma, analyze risk factors and treatment.Method:The clinical data of23patients with hepatolithiasis combined with intrahepatic cholangiocarcinoma in Yanbian University Affiliated Hospital between January1999and January2009were summarized retrospectively, in order to analysis the causes of the disease and treatment. Results:Compared Total number of patients in this group23cases in which the male to female ratio was1:1.3; average age59.2±8.3years old, the youngest45years old, maximum74years; history average of14months, the shortest history of only one week, up to8years.18cases (78.3%) patients with biliary stones history system. Recent frequent episodes of14cases (60.9%). Blood tests in CA19-937u/ml16(69.6%) CA-12535u/ml9(39.1%), AFP9ng/ml8(34.8%), CEA5ng/ml4(17.4%) of all patients with elevated CA19-9were associated with elevated tumor markers of other, independent rise no single tumor marker. Imaging in B-mode ultrasound of the21patients had intrahepatic stones, detection rate was91.3%, occupying two cases of suspected liver (8.7%). Enhanced CT were seen in patients with intrahepatic stones, of which15cases (65.2%) patients with lesions in the left half position liver,9cases (39.1%) patients with the left lobe atrophy.14patients with suspected liver mass detection rate was60.9%, of which13cases of surgical patients, enhanced CT examination of the four cases, accounting for30.8%. MRCP in11patients undergoing routine checks intrahepatic stones were seen in3patients considering liver tumors may check the rate of37.3%. Non-surgical treatment of10patients,6underwent embolization of liver cancer,2cases were followed up for9months and survived13months. Surgery in13patients,9patients of intraoperative diagnosis, follow-up of11cases after an average survival of22.5±8.6months, survived more than5years in2 patients.Conclusion:Intrahepatic stones in elderly patients with history of repeated episodes of abdominal discomfort recent frequent seizures should consider the possibility of intrahepatic cholangiocarcinoma. More likely on the incidence of early stage patients should be enhanced CT. Liver and intrahepatic bile duct stones left predilection sites combined intrahepatic cholangiocarcinoma, and more with the left lobe atrophy. In the early detection of patients with intrahepatic stones should be more inclined to surgery.