原发性胆囊癌51例临床分析

Clinical analysis of 51 cases with primary gallbladder carcinoma

目的总结原发性胆囊癌的诊断及治疗经验。方法回顾分析了我院2000年1月～2005年12月经手术探查的51例胆囊癌患者的临床资料。结果术前诊断30例,肿瘤切除46例。NevinⅠ期10例,行单纯胆囊切除9例,行根治性切除术1例。9例存活超过3年。NevinⅡ期4例,均行根治性切除术,1例存活超过3年。NevinⅢ期7例,行单纯胆囊切除3例,行根治性切除术4例。2例存活超过3年。NevinⅣ期2例,均行根治性切除术,1例存活超过3年。NevinV期28例单纯胆囊切除10例,行根治性切除术9例,行扩大根治术4例,行姑息内引流术3例,剖腹探查2例,无存活超过3年。结论原发性胆囊的癌病理分期及手术方式与预后密切相关。

Objective To summarize the experience of the diagnosis and treatment for primary gallbladder carcinoma. Methods To retrospectively analyze the clinical patholobical data of 51 cases of primary gallbladder carcinoma were adopted from January, 1996 to December, 2005. Results 30 cases were accurately diagnosed before operation. 46 cases were treated with tumor resection. Among 10 cases in Nevin Stage Ⅰ, 9 cases were treated with cholecystectomy, 1 case was treated with radical resection. 9 cases were survived for more than 3 years. All the 4 cases in Nevin Stage Ⅱ were treated with radical resection, 1 cases was survived for more than 3 years. Among 7 cases in Nevin Stage Ⅲ, 3 cases were treated with cholecystectomy, 4 case were treated with radical resection. 2 cases were survived for more than 3 years. All the 2 cases in Nevin Stage Ⅳ were treated with radical resection, 1 cases was survived for more than 3 years. Among 28 cases in Nevin Stage Ⅴ, 10 cases were treated with cholecystectomy, 9 case were treated with radical resection, 4 cases were treated with extended radical resection, 3 cases were treated with palliative cholangio-jejunostomy, 2 cases were only explored. No one case was survived for more than 3 years. Conclusion Pathological stage and operative manner of primary gallbladder carcinoma are correlated with the prognosis.