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고이형성증이 동반된 총담관류 1예

A Case of Choledochocele with High-Grade Dysplasia

  • 류대곤 (부산대학교 의과대학 양산부산대학교병원 내과) ;
  • 김은정 (부산대학교 의과대학 양산부산대학교병원 내과) ;
  • 안은영 (부산대학교 의과대학 양산부산대학교병원 내과) ;
  • 송병준 (부산대학교 의과대학 양산부산대학교병원 내과) ;
  • 강대환 (부산대학교 의과대학 양산부산대학교병원 내과)
  • Ryu, Dae Gon (Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Kim, Eun Jung (Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Ahn, Eun Young (Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Song, Byeong Jun (Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Kang, Dae Hwan (Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine)
  • 투고 : 2013.11.01
  • 심사 : 2013.11.18
  • 발행 : 2014.06.01

초록

이 증례는 특별한 병력이 없던 건강검진 상부위장관 내시경에서 십이지장 종괴가 발견된 환자에서 내시경 역행 췌담관 조영술로 총담관류의 소견을 보여 내시경 유두괄약근 절개술을 시행하였고 조직 검사에서 고이형성증을 동반한 총담관류를 진단하여 광범위 수술까지 진행한 경우이다. 총담관류는 빈도가 매우 드물고 다른 담관 낭종에 비해 악성화 가능성이 낮아서 내시경 유두괄약근 절개술로 치료를 종결하는 것이 대부분이지만 이번 증례처럼 고이형성증이 동반될 수 있으므로 총담관류를 발견하였을 때 유두괄약근절개술 후 절개면을 주의 깊게 관찰하고 철저한 조직 검사와 추적관찰이 필요할 것으로 생각한다.

A type III choledochal cyst, known as a choledochocele, is rare. It is defined as cystic dilatation of the distal common bile duct, protruding into the duodenal lumen. Surgical treatment of a choledochocele remains controversial because it has a low incidence for malignancy compared with other choledochal cysts. While there have been few reported cases of choledochocele with malignancy, here we report our experience of a choledochocele with high-grade dysplasia and provide a literature review of the field.

키워드

참고문헌

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