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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1. 汶雅娟, 马静, 王锋, 等.肝十二指肠韧带的正常解剖及CT研究[J].实用放射学杂志, 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. 闵鹏秋, 林珊, 何之彦, 等.门腔间隙病变CT、MRI特征探讨[J].中华放射学杂志, 1996, 30(1):6-10.
4. 吕梁, 李杰. CT诊断肝十二指肠韧带畸胎瘤1例[J].中国临床医学影像杂志, 2009, 20(1):71.
5. 程刚, 孙志为, 徐安书, 等.肝十二指肠韧带畸胎瘤一例[J].消化肿瘤杂志, 2008, 1(2):92.
6. 王培红, 曹永宽.肝十二指肠韧带巨大畸胎瘤1例[J].西南国防医药, 1996, 6(3):167.
7. 李晓武, 尚培中, 贾国洪, 等.肝十二指肠韧带淋巴管瘤误诊1例[J].河北北方学院学报, 2010, 27(5):61.
8. 陈俏峰.肝十二指肠韧带异位肝一例[J].外科理论与实践, 2011, 16(2):206-207.
9. 杨菲菲, 王家平, 段丽芬, 等.肝十二指肠韧带神经源性肿瘤的MRI诊断[J].放射学实践, 2010, 25(1):63-66.
10. 关泉林, 文天夫, 李波, 等.肝十二指肠韧带淋巴结结核七例诊治分析[J].中华肝胆外科杂志, 2006, 12(5):317-318.
11. 关泉林, 徐长清, 李波, 等.原发性肝十二指肠韧带原发肿块15例分析[J].中国误诊学杂志, 2005, 5(12):2324-2325.
12. 袁林, 沈世强, 杨建青, 等.肝十二指肠韧带淋巴结结核的诊断与治疗[J].国际外科学杂志, 2006, 33(5):335-338.
13. Bhansali SK. Abdominal tuberculosis. Experiences with 300 cases[J]. Am J Gastroenterol, 1977, 67(4):324-337.
14. Gadžijev 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, Nolsøe 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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