º´¸® º¸°í¼
- cholangiocarcinoma(´ã°ü ¹× ´ã³¶¾Ï)
- extrahepatic(°£¿Ü)
- Intraductal growth type(´ã°ü³» ¼ºÀåÇü)
- adenocarcinoma ,well differentiated (°íºÐÈ È£»ê¼º °ú¸³¼¼Æ÷¾ÏÁ¾)
<ºÐÈ»óÅ¿¡ µû¶ó well, poorly, undifferentiated, µîÀ¸·Î °¥¸². ¹ÌºÐÈÀϼö·Ï ¾Ç¼ºµµ ³ôÀ½>
- arising from Intraductal Papillary Neoplasm of the Bile duct (IPNB), multiple, up to1.5x1.3X1.0CM
distal common bile duct[¿øÀ§ºÎ ÃÑ´ã°ü]
(¿øÀ§ºÎ ÃÑ´ã°ü ³» ´Ù¼öÀÇ??? À¯µÎÁ¾¾çÀ¸·Î ºÎÅÍ ¹ß»ý, »çÀÌÁî 1.5 1.3 1.0)
1) confinement to bile duct wall (´ã°üº®¿¡ ±¹ÇÑ)
2) no involvement of ampulla of Vater[¹ÙÅÍÆØ´ëºÎ], duodenal wall[½ÊÀÌÁöÀ庮] and pancreas[ÃéÀå]
(¹ÙÅÍÆØ´ëºÎ ½ÊÀÌÁöÀ庮 ÃéÀå ħ¹ü¾øÀ½)
3) lymphovascular invasion : not identified(¸²ÇÁÇ÷°ü° ħ¹ü¾øÀ½)
4) perineural invasion : not identified(½Å°æÁÖÀ§ ħ¹ü ¾øÀ½)
5) no involvement of peripancreatic radial[ÃéÀå ÁÖº¯], pancreatic[ÃéÀå], common bile duct[ÃÑ´ã°ü], proximal duodenal[±ÙÀ§ºÎ ½ÊÀÌÁöÀå] and distal jejunal resction margins.[¿øÀ§ºÎ °øÀå ÀýÁ¦¸éµé]
(ÃéÀå ÁÖº¯, ÃéÀå, ÃÑ´ã°ü, ±ÙÀ§ºÎ ½ÊÀÌÁöÀå, ¿øÀ§ºÎ °øÀå ÀýÁ¦¸éµé ħ¹ü ¾øÀ½)
6) no metastasis in 12 lymp nodes (0/12) (12°³ÀÇ ¸²ÇÁÀý¿¡ ÀüÀÌ ¾øÀ½)
(LN #8, 0/2; regional LN, 0/10)
=======================================
1.
¼ö¼ú ÈÄ Á¶Á÷°Ë»ç °á°úÀ̸ç
Çѱ۷ΠÀûÈù ºÎºÐÀº Á¦°¡ ³ª¸§´ë·Î Çؼ®ÇÑ ºÎºÐÀÔ´Ï´Ù.
Á¦°¡ Çؼ®ÇÑ°Í Áß Æ²¸°ºÎºÐÀ̳ª Ãß°¡ÇØ¾ßµÉ »çÇ×ÀÌ ÀÖ´ÂÁö,,
µµ¿ÍÁÖ½Ã¸é °¨»çÇÏ°Ú½À´Ï´Ù.
À§ º»¹®Áß¿¡ multiple ÀÌ ¹«¾ùÀ» ÀǹÌÇÏ´ÂÁö ±Ã±ÝÇϳ׿ä
2. Intraductal growth type(´ã°ü³» ¼ºÀåÇü) À¸·Î °á°ú°¡ ³ª¿Ô´Âµ¥
º¸ÆíÀûÀ¸·Î ħÀ±ÇüÀÌ ¸¹Àº °ÍÀ¸·Î ¾Ë°í ÀÖ½À´Ï´Ù.
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3. ¸¶Áö¸·À¸·Î ÀÌÁ¤µµ º´±â¸é
¾î´ÀÁ¤µµ ÁøÇàÀÌ µÈ°ÇÁö,,
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