内镜逆行胰胆管造影联合SpyGlass确诊胆囊黏液腺瘤1例报告

卢心毓; 王林恒; 江贵; 云逸飞; 黄朔; 张丽杰

doi:10.3969/j.issn.1001-5256.2023.05.025

内镜逆行胰胆管造影联合SpyGlass确诊胆囊黏液腺瘤1例报告

DOI: 10.3969/j.issn.1001-5256.2023.05.025

北京中医药大学东方医院脾胃肝胆科, 北京 100078

基金项目:

北京中医药大学重点攻关项目 (2020-JYB-ZDGG-132)

伦理学审查：本例报告已获得患者知情同意。

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：卢心毓负责查阅文献，分析资料，撰写论文；王林恒指导写作思路及研究内容的分析解释；江贵、云逸飞、黄朔对研究的思路及设计有贡献；张丽杰拟定写作思路，指导撰写，修改文章关键内容并最终定稿。

详细信息

通信作者:
张丽杰, 857366167@qq.com (ORCID: 0000-0001-6008-2066)

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- 被引次数: 0
出版历程
- 收稿日期: 2022-08-26
- 录用日期: 2022-10-12
- 出版日期: 2023-05-20

Mucinous gallbladder adenoma diagnosed by endoscopic retrograde cholangiopancreatography and SpyGlass: A case report

Spleen, Stomach and Hepatobiliary Department, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100078, China

Research funding:

Key Research Project of Beijing University of Chinese Medicine (2020-JYB-ZDGG-132)

More Information

Corresponding author: ZHANG Lijie, 857366167@qq.com (ORCID: 0000-0001-6008-2066)

摘要

- 胆囊黏液腺瘤 /
- 胰胆管造影术, 内窥镜逆行 /
- SpyGlass /
- 诊断, 鉴别
- Mucinous Gallbladder Adenoma /
- Cholangiopancreatography, Endoscopic Retrograde /
- SpyGlass /
- Diagnosis, Differential

HTML全文

图 1 ERCP术前腹部CT

注：a，胆囊未见显示；b，胆总管扩张；c，胆总管下段截断。

Figure 1. Abodominal CT before ERCP

下载: 全尺寸图片幻灯片

图 2 ERCP及SpyGlass观察

注：a，SpyGlass观察胆囊颈管，见管壁鱼卵样增生；b，SpyGlass观察胆囊，见胆囊内壁乳头瘤样增生并附着较多黏液；c，取石网篮拖取出胶冻样黏液及泥沙样结石；d，ERCP下放置鼻胆引流管于胆总管处。

Figure 2. Observation of ERCP and SpyGlass

下载: 全尺寸图片幻灯片

图 3 胆囊组织病理结果

注：a，HE染色，×40；b~d，HE染色，×400。

Figure 3. Pathology result of gallbladder

下载: 全尺寸图片幻灯片

参考文献(18)

[1]	ALBORES-SAAVEDRA J, HENSON DE, SOBIN LH. The WHO histological classification of tumors of the gallbladder and extrahepatic bile ducts. A commentary on the second edition[J]. Cancer, 1992, 70(2): 410-414. DOI: 10.1002/1097-0142(19920715)70:2<410::aid-cncr2820700207>3.0.co;2-r.
[2]	KOZUKA S, TSUBONE N, YASUI A, et al. Relation of adenoma to carcinoma in the gallbladder[J]. Cancer, 1982, 50(10): 2226-2234. DOI: 10.1002/1097-0142(19821115)50:10<2226::aid-cncr2820501043>3.0.co;2-3.
[3]	LIANG L, SUN B, ZHANG HZ, et al. Analysis of clinical characteristics of 48 cases of gallbladder adenoma based on different pathological grades[J]. J Shandong Univ (Health Sciences), 2021, 59(1): 59-63. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYB202101011.htm 梁荔, 孙斌, 张洪战, 等. 基于不同病理分级的48例胆囊腺瘤临床特点分析[J]. 山东大学学报(医学版), 2021, 59(1): 59-63. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYB202101011.htm
[4]	ZHANG BY, GE CL. Analysis of related factors of carcinogenesis of gallbladder adenoma[J]. Mod Oncol, 2019, 27(22): 4026-4028. DOI: 10.3969/j.issn.1672-4992.2019.22.021. 张禀业, 葛春林. 胆囊腺瘤癌变的相关因素分析[J]. 现代肿瘤医学, 2019, 27(22): 4026-4028. DOI: 10.3969/j.issn.1672-4992.2019.22.021.
[5]	LI KY, LIU LX. Progress in diagnosis and treatment of gallbladder adenoma carcinogensis[J]. Chin J Pract Surg, 2015, 35(7): 794-796. DOI: 10.7504/CJPS.ISSN1005-2208.2015.07.28. 李轲宇, 刘连新. 胆囊腺瘤癌变诊治进展[J]. 中国实用外科杂志, 2015, 35(7): 794-796. DOI: 10.7504/CJPS.ISSN1005-2208.2015.07.28.
[6]	SUN XH, WANG YJ, ZHANG W, et al. Epidemiological characteristics, diagnosis, treatment and prognosis of gallbladder cancer in China: a report of 6159 cases[J]. Chin J Dig Surg, 2022, 21(1): 114-128. DOI: 10.3760/cma.j.cn115610-20220103-00004. 孙旭恒, 王一钧, 张薇, 等. 中国胆囊癌流行病学特征与诊治及预后分析(附6159例报告)[J]. 中华消化外科杂志, 2022, 21(1): 114-128. DOI: 10.3760/cma.j.cn115610-20220103-00004.
[7]	YU MH, KIM YJ, PARK HS, et al. Benign gallbladder diseases: Imaging techniques and tips for differentiating with malignant gallbladder diseases[J]. World J Gastroenterol, 2020, 26(22): 2967-2986. DOI: 10.3748/wjg.v26.i22.2967.
[8]	ZHANG C, CHEN L, YU RS. MRI diagnosis of gallbladder adenoma and partial malignant transformation[J]. J Clin Radiol, 2016, 35(1): 85-88. DOI: 10.13437/j.cnki.jcr.2016.01.024. 张超, 陈璐, 余日胜. 胆囊腺瘤及其局部癌变的MRI诊断[J]. 临床放射学杂志, 2016, 35(1): 85-88. DOI: 10.13437/j.cnki.jcr.2016.01.024.
[9]	LIU F, MAO WB, FANG ZW, et al. CT features of carcinogenesis in gallbladder adenoma[J]. Diagn Imag Interv Radiol, 2020, 29(4): 265-270. DOI: 10.3969/j.issn.1005-8001.2020.04.005. 刘锋, 毛伍兵, 方字文, 等. 胆囊腺瘤的CT影像特征及分析[J]. 影像诊断与介入放射学, 2020, 29(4): 265-270. DOI: 10.3969/j.issn.1005-8001.2020.04.005.
[10]	YANG M, LIU N, WANG X. The value of CT enhanced scan in the comprehensive diagnosis of gallbladder polypoid lesions[J]. J Hepatobiliary Surg, 2020, 28(3): 204-207. DOI: 10.3969/j.issn.1006-4761.2020.03.011. 杨明, 刘宁, 王星. CT增强扫描对胆囊息肉样病变的综合诊断价值分析[J]. 肝胆外科杂志, 2020, 28(3): 204-207. DOI: 10.3969/j.issn.1006-4761.2020.03.011.
[11]	XIONG DD, ZHU L, ZENG CY, et al. Spyglass visual impression and Spybite targeted biopsies for diagnosis of biliary strictures of unknown reasons: a meta-analysis[J]. Chin J Dig Endosc, 2018, 35(8): 583-589. DOI: 10.3760/cma.j.issn.1007-5232.2018.08.012. 熊丹丹, 朱亮, 曾春艳, 等. Spyglass直视系统及Spybite目标活检对不明原因胆道狭窄良恶性鉴别的Meta分析[J]. 中华消化内镜杂志, 2018, 35(8): 583-589. DOI: 10.3760/cma.j.issn.1007-5232.2018.08.012.
[12]	WANG Y, PENG YH. Clinical progress of SpyGlass system in diagnosis and treatment of biliary tract diseases[J]. Chin J Clin Ration Drug Use, 2021, 14(1): 174-176. DOI: 10.15887/j.cnki.13-1389/r.2021.01.076. 王宇, 彭彦辉. SpyGlass系统在胆道疾病诊疗中的临床进展[J]. 临床合理用药杂志, 2021, 14(1): 174-176. DOI: 10.15887/j.cnki.13-1389/r.2021.01.076.
[13]	ERCP group, Chinese Society of Digestive Endoscopology, Biliopancreatic group, Chinese Association of Gastroenterologist and Hepatologist, National Clinical Research Center for Digestive Diseases. Chinese Guidelines for ERCP(2018)[J]. J Clin Hepatol, 2018, 34(12): 2537-2554. DOI: 10.3969/j.issn.1001-5256.2018.12.009. 中华医学会消化内镜学分会ERCP学组, 中国医师协会消化医师分会胆胰学组, 国家消化系统疾病临床医学研究中心. 中国经内镜逆行胰胆管造影术指南(2018版)[J]. 临床肝胆病杂志, 2018, 34(12): 2537-2554. DOI: 10.3969/j.issn.1001-5256.2018.12.009.
[14]	WIM L, KRISTOF V, van STEENBERGEN WERNER, et al. Usefulness of the single-operator cholangioscopy system SpyGlass in biliary disease: a single-center prospective cohort study and aggregated review[J]. Surg Endosc, 2017, 31(5): 2223-2232. DOI: 10.1007/s00464-016-5221-2.
[15]	ZHAO D, ZHANG Z, HUANG YM, et al. Preliminary exploration of SpyGlass direct visualization system in diagnosis and treatment of biliary stricture after liver transplantation[J]. Ogran Transplant, 2022, 13(1): 55-60. DOI: 10.3969/j.issn.1674-7445.2022.01.009. 赵东, 张卓, 黄一鸣, 等. SpyGlass直视系统在肝移植术后胆道狭窄诊治中的初步探索[J]. 器官移植, 2022, 13(1): 55-60. DOI: 10.3969/j.issn.1674-7445.2022.01.009.
[16]	ZHANG M, WANG X, ZHANG K. Application of laser lithotripsy under SpyGlass in difficult pancreatic duct stones (with video)[J]. Chin J Dig Endosc, 2021, 38(9): 737-739. DOI: 10.3760/cma.j.cn321463-20201214-00973. 张明, 王翔, 张锎. SpyGlass直视下激光碎石在困难胰管结石中的应用(含视频)[J]. 中华消化内镜杂志, 2021, 38(9): 737-739. DOI: 10.3760/cma.j.cn321463-20201214-00973.
[17]	ZHANG H, XIAO L, ZOU H, et al. Application of SpyGlass direct visualization system in diagnosis and treatment of biliary diseases[J]. China J Endosc, 2019, 25(2): 1-5. DOI: 10.3969/j.issn.1007-1989.2019.02.001. 张航, 肖乐, 邹洪, 等. SpyGlass直视化系统在胆管疾病诊断和治疗中的应用[J]. 中国内镜杂志, 2019, 25(2): 1-5. DOI: 10.3969/j.issn.1007-1989.2019.02.001.
[18]	Chinese Anti-Cancer Association. Guideline for the diagnosis and therapy of gallbladder carcinoma (2016)[J]. J Clin Hepatol, 2017, 33(4): 611-620. DOI: 10.3969/j.issn.1001-5256.2017.04.002. 中国抗癌协会. 胆囊癌规范化诊治专家共识(2016)[J]. 临床肝胆病杂志, 2017, 33(4): 611-620. DOI: 10.3969/j.issn.1001-5256.2017.04.002.