摘要
目的探讨腹腔镜胆囊切除术(LC)相关的意外胆囊癌(UGC)的诊治方法。方法对在1995年1月至2008年12月4520例Lc术中、术后发现的15例UGC患者的临床资料进行回顾性分析。结果15例UGC术中发现7例,术后发现8例,所有病例术后进行病理检查及Nevin分期,Ⅰ期4例,Ⅱ期7例,Ⅲ期3例,Ⅳ期1例。Ⅰ期仅行LC;Ⅱ、Ⅲ期行胆囊癌根治术;Ⅳ期行扩大根治术。15例患者术后随访6个月至5年,3例5年内死亡,12例5年随访时仍存活,5年生存率为80.O%。结论LC相关的UGC以早期癌为主,术中对高危患者及可疑者做快速病理检查有助于UGC的发现。NevinI期病例行LC可达到根治目的,NevinⅡ-Ⅳ期病例需开腹行根治术。
Objective To explore the diagnosis and treatment of unsuspected gallbladder cancer (UGC) related with laparoscopic cholecystectomy (LC). Methods From January 1995 to Dece m bet 2008,4520 cases of LC were performed, UGC was discovered in 15 cases. Clinical data of the 15 cases were analyzed retrospectively. Results Among the 15 cases of UGC, 7 were discovered intraoperatively, and 8 were diagnosed postoperatively. Postoperative pathological examination showed Nevin stage Ⅰ in 4 cases, stage Ⅱ in 7 cases, stage Ⅲ in 3 cases, stage Ⅳ in 1 case. LC was carried out in the patients of Nevin stage Ⅰ. Radical resection of gallbladder cancer was performed on the patients at stage Ⅲ and stage In. One patient at stage received extended radical resection. The patients were followed up from 6 months to 5 years,during the period 3 cases were died and 12 cases were still alive, the 5-year survival rate was 80.0%. Conclusions Most of LC-related UGC cases are early cancer. Frozen section examination should be performed for high-risk groups and suspicious persons, which contributes to the discovery of UGC. LC can achieve the radical purpose of Nevin stage Ⅰ patients, Nevin stage Ⅱ -Ⅳrequires open radical operation.
出处
《中国医师进修杂志》
2010年第2期14-15,共2页
Chinese Journal of Postgraduates of Medicine
关键词
胆囊切除术
腹腔镜
胆囊肿瘤
意外
Cholecysteetomy,laparoscopic
Gallbladder neoplasms
Unplanned