Diagnosis and Treatment on Primary Mass of The Hepatoduodenal Ligament:Report of 16 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 GUODongming , LIChuan ,  WENTian-fu , YANGJian , WANGMing , YUYu , ZHANGXiao-yun

Division of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding?author：

WENTian-fu, Email: ccwentianfu@sohu.com

Keywords：

Primary mass; Hepatoduodenal ligament; Diagnosis; Treatment

DOI：

10.7507/1007-9424.20140199

Video：

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Objective To investigate the clinical characteristics of primary mass of the hepatoduodenal ligament (HDL) and present some thoughts in the diagnosis and treatment of this disease. Methods Sixteen consecutive patients diagnosed as having a primary mass of the HDL in the West China Hospital of Sichuan University from September 2004 to May 2013 were retrospectively investigated. Results The symptoms and blood testing both lacked specificity. In this group, fourteen patients were examined by ultrasound and fifteen by contrast-enhanced computed tomography, with 3/14 (21.43%) and 5/15(33.33%) respectively defining the location of the lesions and characteristic of benign/malignant. When combining the ultrasound and contrast-enhanced computed tomography, six of twelve(50.00%) defined the location and characteristic of benign/malignant. When combined with contrast-enhanced magnetic resonance, ten of sixteen (62.5%) defined the location and characteristic of benign/malignant. All cases underwent abdominal exploration, 11 cases (68.8%) were porformed mass resected, 2 cases(12.5%) were porformed the simple HDL mass biopsy combined with biliary drainage with T tube, 1 case(6.2%) was porformed drainage for abscess of HDL, and 2 cases(12.5%) were porformed simple frozen biopsy. All cases recovered and discharged. Conclusions The diagnosis of a primary mass of the HDL is difficult. The united usage of multiple imageological examinations can increase the accuracy rate of the noninvasive preoperative diagnosis. Surgery and other active treatment can produce good prognosis.

Citation： GUODongming, LIChuan, WENTian-fu, YANGJian, WANGMing, YUYu, ZHANGXiao-yun. Diagnosis and Treatment on Primary Mass of The Hepatoduodenal Ligament:Report of 16 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(7): 841-845. doi: 10.7507/1007-9424.20140199 Copy

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25.	Onders RP, Mittendorf EA. Utility of laparoscopy in chronic abdominal pain[J]. Surgery, 2003, 134(4):549-552.

1. ?汶雅娟, 馬靜, 王鋒, 等.肝十二指腸韌帶的正常解剖及CT研究[J].實用放射學雜志, 2003, 19(2):128-130.
2. Ito K, Choji T, Fujita T, et al. Imaging of the portacaval space[J]. AJR. Am J Roentgenol, 1993, 161(2):329-334.
3. 閔鵬秋, 林珊, 何之彥, 等.門腔間隙病變CT、MRI特征探討[J].中華放射學雜志, 1996, 30(1):6-10.
4. 呂梁, 李杰. CT診斷肝十二指腸韌帶畸胎瘤1例[J].中國臨床醫學影像雜志, 2009, 20(1):71.
5. 程剛, 孫志為, 徐安書, 等.肝十二指腸韌帶畸胎瘤一例[J].消化腫瘤雜志, 2008, 1(2):92.
6. 王培紅, 曹永寬.肝十二指腸韌帶巨大畸胎瘤1例[J].西南國防醫藥, 1996, 6(3):167.
7. 李曉武, 尚培中, 賈國洪, 等.肝十二指腸韌帶淋巴管瘤誤診1例[J].河北北方學院學報, 2010, 27(5):61.
8. 陳俏峰.肝十二指腸韌帶異位肝一例[J].外科理論與實踐, 2011, 16(2):206-207.
9. 楊菲菲, 王家平, 段麗芬, 等.肝十二指腸韌帶神經源性腫瘤的MRI診斷[J].放射學實踐, 2010, 25(1):63-66.
10. 關泉林, 文天夫, 李波, 等.肝十二指腸韌帶淋巴結結核七例診治分析[J].中華肝膽外科雜志, 2006, 12(5):317-318.
11. 關泉林, 徐長清, 李波, 等.原發性肝十二指腸韌帶原發腫塊15例分析[J].中國誤診學雜志, 2005, 5(12):2324-2325.
12. 袁林, 沈世強, 楊建青, 等.肝十二指腸韌帶淋巴結結核的診斷與治療[J].國際外科學雜志, 2006, 33(5):335-338.
13. Bhansali SK. Abdominal tuberculosis. Experiences with 300 cases[J]. Am J Gastroenterol, 1977, 67(4):324-337.
14. Gad?ijev EM. Surgical anatomy of hepatoduodenal ligament and hepatic hilus[J]. J Hepatobiliary Pancreat Surg, 2002, 9(5): 531-533.
15. Weinstein JB, Heiken JP, Lee JK, et al. High resolution CT of the porta hepatis and hepatoduodenal ligament[J]. Radiographics, 1986, 6(1):55-74.
16. Dietrich CF, Gottschalk R, Herrmann G, et al. Sonographic detection of lymph nodes in the hepatoduodenal ligament[J]. Dtsch Med Wochenschr, 1997, 122(42):1269-1274.
17. Roethlin M, Largiader F. The anatomy of the hepatoduodenal ligament in laparoscopic sonography[J]. Surg Endosc, 1994, 8(3):173-180.
18. Bertolotto M, Dalla Palma L, Quaia E, et al. Characterization of unifocal liver lesions with pulse inversion harmonic imaging after Levovist injection:preliminary results[J]. Eur Radiol, 2000, 10(9):1369-1376.
19. Burns PN, Wilson SR, Simpson DH. Pulse inversion imaging of liver blood flow:improved method for characterizing focal masses with microbubble contrast[J]. Invest Radiol, 2000, 35(1):58-71.
20. Piscaglia F, Nols?e C, Dietrich CF, et al. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS):update 2011 on non-hepatic applications[J]. Ultraschall Med, 2012, 33(1):33-59.
21. Claudon M, Cosgrove D, Albrecht T, et al. Guidelines and Good Clinical Practice Recommenda-tions for Contrast Enhanced Ultrasound (CEUS)-Update 2008[J]. Ultraschall Med, 2008, 29(1):28-44.
22. Lu MD, Yu XL, Li AH, et al. Comparison of contrast enhanced ultrasound and contrast enhanced CT or MRI in monitoring percutaneous thermal ablation procedure in patients with hepatocellular carcinoma:a multi-center study in China[J]. Ultrasound Med Biol, 2007, 33(11):1736-1749.
23. Amarapurkar D, Bhatt N, Patel N, et al. Diagnostic laparoscopy in the era of modern imaging--retrospective analysis from a single center[J]. Indian J Gastroenterol, 2013, 32(5):302-306.
24. Salky BA, Edye MB. The role of laparoscopy in the diagnosis and treatment of abdominal pain syndromes[J]. Surg Endosc, 1998, 12(7):911-914.
25. Onders RP, Mittendorf EA. Utility of laparoscopy in chronic abdominal pain[J]. Surgery, 2003, 134(4):549-552.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment on Primary Mass of The Hepatoduodenal Ligament:Report of 16 Cases

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