目的    探讨肝内胆管囊腺瘤的诊断和治疗。 方法    回顾性分析2003年1月至2009年12月中国医科大学附属盛京医院收治的17例肝内胆管囊腺瘤病人的临床资料。 结果    主要临床表现为上腹部不适或疼痛。2例曾误诊为肝囊肿行开窗引流术。6例病人CA19-9升高，1例甲胎蛋白（AFP）轻度升高，癌胚抗原（CEA）水平均正常。7例术前影像学检查确诊。均行根治性肝切除手术。病理结果显示肝内胆管囊腺瘤14例，胆管囊腺瘤恶变3例。术后随访8~60个月无复发。 结论    肝内胆管囊腺瘤术前难以确诊，易恶变，根治性肝切除手术疗效满意。

Diagnosis and treatment of intrahepatic biliary cystadenoma: an analysis of 17 cases        LIU Yuan, ZHOU Yong, GENG Dong-hua, et al. Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
Corresponding author: LIU Jin-gang, E-mail:liujg@sj-hospital.org
Abstract    Objective    To study the diagnosis and treatment of intrahepatic biliary cystadenoma. Methods    The clinical data of 17 cases of intrahepatic biliary cystadenoma admitted between January 2003 and December 2009 in Shengjing Hospital of China Medical University were analyzed retrospectively. Results    The majority of 17 cases presented as upper abdominal discomfort or pain. Tow cases had undergone previous unroofing of the cyst for misdiagnosis as simple liver cyst. Abnormal serous carbohydrate antigen 19-9 (CA19-9) was observed in 6 cases.  Serous alpha-fetoprotein (AFP) level was slightly elevated in one case, and serous carcinoembryonic antigen (CEA) was normal in all cases. Seven cases were diagnosed correctly according to imaging examination. All the cases underwent total resection of the cyst. Pathological diagnosis was intrahepatic biliary cystadenoma in all the 17 cases, and 3 of them showed malignant change. No recurrence was found after followed up for 8 to 60 months. Conclusion    Preoperative diagnosis of intrahepatic biliary cystadenoma is difficult. Intrahepatic biliary cystadenoma is easy to develop to cystadenocarcinoma. The prognosis of radical resection is satisfied.