腹腔镜手术意外发现胆囊癌的诊治体会

The Treatment Experience of Unexpected Gallbladder Carainoma Intraoperative Laparoscopic

目的:探讨腹腔镜胆囊切除术中(laparoscopic cholecystectomy,LC)遇到意外胆囊癌(unexpected gallbladder carcinoma,UGC)的诊断和治疗。方法:回顾性分析我院1998年6月-2010年12月LC术中遇到的11例意外胆囊癌的临床资料。结果:术中探查结合快速病理明确诊断8例,3例术后石蜡病理证实为胆囊癌。开腹手术6例,单纯腹腔镜胆囊切除2例,3例腹腔内广泛转移,行腹腔镜胆囊姑息性切除术;结论:行LC前应加强对胆囊癌的警惕与认识。术中应常规检查胆囊标本,有怀疑者及时行冰冻切片检查。UGC确诊后应尽早开腹行根治性和扩大根治性切除术,并采取必要措施防止肿瘤种植转移。

Objective： To investigate the diagnosis and treatment of unexpected gallbladder carainoma intraperative Laparoscopic Cholecystectomy（LC）.Methods： Eleven cases clinic datas of unexpected gallbladder carcinoma intraperative Laparoscopic Cholecystec-tomy（LC）,from June 1998 to December 2010 in our hospital were retrospectively reviewed.Results： Eight cases were clearly diagno-sised by intraperative exploratiom and pathology,and 3 cases were proved by postoperative pathology.6 cases underwent Laparotomy,and 2 cases for LC,and 3 cases had carcinoma extensively migrated in abdomen.Conclusions： It is necessary to strengthen alert to and comprehension of gallbladder carcinoma before operation,and to regularly examine gallbladder intra operation.Suspected gallbladder sample should be taken biopsy timely.It is as early as possible to take essential measure such as radical or expand excision to avoid tumor transcoelomic metastasis.