{"created":"2023-07-27T06:38:41.674977+00:00","id":26849,"links":{},"metadata":{"_buckets":{"deposit":"752c5ca9-3a84-46ef-a3c2-6445bff3dac9"},"_deposit":{"created_by":3,"id":"26849","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"26849"},"status":"published"},"_oai":{"id":"oai:kanazawa-u.repo.nii.ac.jp:00026849","sets":["1761:1762:1763"]},"author_link":["583","595","116","382","92","45381","537","404","21810","1009","642"],"item_4_biblio_info_8":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2013-05-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"5","bibliographicPageEnd":"412","bibliographicPageStart":"403","bibliographicVolumeNumber":"34","bibliographic_titles":[{"bibliographic_title":"胆と膵 = The Biliary tract & pancreas"}]}]},"item_4_description_21":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は60歳代男性. 既往歴に胆嚢摘出術あり(40歳時, 胆石症). 今回, 前医にて肝機能障害が指摘され, 総胆管腫瘍が疑われたため, 精査加療目的に当院紹介受診となった. 血液生化学検査では肝胆道系酵素の上昇を認める以外, 特記事項なく, 腫瘍マーカーにも異常は認めなかった. 腹部超音波検査では肝外胆管・肝内胆管の高度拡張を認め, 上～中部胆管では内腔に突出する乳頭状腫瘤を認めた. CTでは総胆管の紡錘状の拡張および胆管壁の肥厚を認め, 内腔に乳頭状に突出する比較的淡い造影効果を呈する腫瘍を認めた. MRIではT2強調像, MRCPにおいて上～中部胆管に不整な欠損像を認めた. 内視鏡的に乳頭腫大を認め, 胆道造影では肝内胆管～下部胆管の拡張を, 上部から中部胆管には不整な造影欠損域を認めた. 乳頭切開術を施行したところ粘液の流出を認めた. 胆汁細胞診ではnegative, 胆道生検では類円形の核と粘液を有する明るい胞体を有した細胞の乳頭状増殖を認めた.","subitem_description_type":"Abstract"}]},"item_4_publisher_17":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"医学図書出版"}]},"item_4_relation_28":{"attribute_name":"関連URI","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"http://www.igakutosho.co.jp/","subitem_relation_type_select":"URI"}}]},"item_4_rights_23":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"Copyright © 医学図書出版 | 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