胆囊癌诊治中几个值得关注的问题

Some questions of diagnosis and treatment in gallbladder carcinoma

胆囊癌发现晚,转移早,恶性程度高,预后差。胆囊癌诊治中的热点、难点问题一直备受关注并存在争议。早期、准确的诊断能够改善病人的预后,根治性切除是有效延长胆囊癌病人生存期的重要手段。科学、合理的肿瘤分期不仅可以提示病程,还可以指导术式选择及预后判断。临床工作中应重视意外胆囊癌的根治性治疗及晚期胆囊癌的综合治疗,并将胆囊癌术前腹腔镜探查作为常规。在加强胆囊癌临床与基础研究的同时,进一步重视、规范胆囊癌的综合治疗,建立胆道肿瘤外科专业化队伍。

Gallbladder carcinoma has been considered the malignancy with dismal prognosis due to its propensity for early dissemination and delayed diagnosis at an advanced tumor stage, and the improved survival could be obtained by the early and precise diagnosis. Surgical radical resection with tumor-free margins provides the only method for long-term survival. Scientific tumor staging system could not only indicate the tumor stage but also do favor for the choice of operation and prediction of prognosis. Unnecessary laparotomy could be avoided by routinely staging laparoscopy. More attention should be paid to the radical resection of incidental gallbladder carcinoma and comprehensive treatment of advanced gallbladder carcinoma. With the development of clinical and basic research of gallbladder carcinoma, comprehensive and standardized treatment, as well as the establishment of professional team on biliary tract carcinoma surgery should also be emphasized.