[Prophylactic surgery for hepatic and biliary tumors].

Alexandra Nassar, Maria Conticchio, Marie-Julie Lardinois, Juliette Benedetti, Lisa Lartigau, Ugo Marchese, Stylianos Tzedakis, David Fuks
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Abstract

Benign tumors of the liver and biliary tract are rare entities, and some of them require surgical management to prevent their malignant transformation. Tumors from the biliary tract with malignant potential are treated either by hepatic resection, for mucinous cystic neoplasm and ciliated hepatic foregut cysts, or by biliary resections, for biliary papillary neoplasm and type I and IV choledochal cysts. The pathologies requiring prophylactic cholecystectomy are polyps larger than 10 mm, porcelain gallbladder and pancreaticobiliary maljunction. Finally, hepatocellular adenoma over 5cm, occurring in male patients, or exon 3 mutated beta-catenin, should lead to prophylactic resection by hepatic segmentectomy. This article describes these different pathologies and their management.

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[肝胆肿瘤的预防性手术]。
肝脏和胆道的良性肿瘤非常罕见,其中一些需要手术治疗,以防止恶变。对于有恶变可能的胆道肿瘤,可通过肝切除术治疗粘液性囊腺瘤和纤毛肝前肠囊肿,或通过胆道切除术治疗胆道乳头状瘤和 I 型及 IV 型胆总管囊肿。需要进行预防性胆囊切除术的病变是大于 10 毫米的息肉、瓷胆囊和胰胆管连接不良。最后,男性患者中出现的超过 5 厘米的肝细胞腺瘤或 beta-catenin 第 3 外显子突变,应通过肝段切除术进行预防性切除。本文介绍了这些不同的病理变化及其治疗方法。
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