高龄胆囊癌48例外科诊治分析

Gallbladder carcinoma in the elderly： a report of 48 patients

目的探讨70岁以上高龄胆囊癌的早期诊断及外科治疗方法。方法回顾性分析2003年至2010年我院收治的48例70岁以上高龄原发性胆囊癌患者的临床资料。结果全组术前诊断率为60．4％；48例胆囊癌患者中，实施单纯胆囊切除术9例，标准根治性切除术18例，扩大根治术7例，姑息性手术8例，腹腔内广泛转移而仅取活检6例。原发性胆囊癌术后3年生存率为20．8％，5年生存率为8．3％。结论高龄人的慢性胆囊疾病定期行B超、CT或磁共振（MRI）检查，可提高胆囊癌的早期诊断率。高龄胆囊癌根据临床分期争取根治手术。术后中西医结合治疗可改善高龄胆囊癌的预后。

Objective To review the diagnosis and treatment of primary gallbladder carcinoma in patients older than 70 years. Method The clinical data of 48 patients older than 70 years with primary gallbladder carcinoma treated in our hospital from 2003 to 2010 were retrospectively analyzed. Results The preoperative diagnostic rate was 60.4%. Of 48 patients with primary gallbladder carcinoma, 9 received cholecystectomy, 18 radical resection, 7 extended radical resection, 8 palliative operation, while the remaining 6 received biopsy because of metastasis. The 3 year survival rate was 20.8% and the 5-year survival rate was 8.3 %. Conclusions Regular B-ultrasonography, CT-scan and MRI are suggested for elderly patients with chronic diseases of the gallbladder. Radical resection is recommended if clinically possible. Chinese traditional medicine given postoperatively improved the prognosis.