30例胆囊癌患者行腹腔镜胆囊切除术后的生存分析

The survival analysis of 30 cases with gallbladder cancer by laparoscopic cholecystectomy

目的:探讨不同病理分期胆囊癌患者经腹腔镜切除胆囊的生存率和生存期以及可行性。方法:对1995年1月～2006年6月经腹腔镜意外发现的胆囊癌30例患者进行TNM分期,其中T1a9例,T1b6例,T2期3例,T3期12例,均接受了腹腔镜胆囊切除术,术后接受定期检查和随访,观察其不同病理分期的生存率和生存期,并进行生存分析。结果:T1a期和T1b期术后的生存率均为100%,生存期分别为(80.56±10.28)个月和(79.67±19.87)个月,无统计学差异。T2期和T3期胆囊癌术后生存率分别为100%和36.36%,生存期分别为(28.00±6.93)个月和(23.80±5.22)个月,显著低于T1a和T1b期。结论:T1a和T1b期胆囊癌患者经腹腔镜切除胆囊是可行的,生存率高、生存期长。对T2和T3期胆囊癌患者必须采用开腹手术。

Objective： To study the postoperative survival rate,live time and feasibility of gallbladder cancer with different pathological stage treated by laparoscopic cholecystectomy （LC）. Methods： From January 1995 to June 2006,30 cases with gallbladder cancer were incidentally found by laparoscope. Accordant to TNM criteria, these cases were recognized as 9 cases with T1 a ,6 cases with T1 b,3 cases with T2 and 12 cases with T3. They all received laparoscopic cholecystectomy and got physical checking and following up regularly. Postoperative survival rate and live time were observed and analyzed. Results： Both the postoperative survival rate of cases with T1 a and T1 b were 100% , and survival time were （80.56± 10.28 ） months and （79.67 ± 19.87 ） months respectively. The different between them was no significant. Both of the postoperative survival rate of cases with T2 and T3 was 100% and 36.36 % respectively, and survival time was （ 28.00±6.93 ） months and （ 23.80 ± 5.22 ） months respectively. Their findings were less than ones with T1 a and T1 b significantly. Conclusions： Cases with T1a and T1b gallbladder cancer may treat by laparoscopic cholecystectomy, but cases with T2 and T3 gallbladder cancer should undergo an open abdominal surgery.