意外胆囊癌11例临床分析

Clinical analysis of 11 cases with unexpected gallbladder caricinoma

目的探讨意外胆囊癌的诊断和治疗。方法回顾性分析2005年1月～2009年12月笔者所在医院收治的11例意外胆囊癌患者的临床资料。结果开腹胆囊切除术4例,腹腔镜胆囊切除术7例。术中冰冻切片证实胆囊癌3例,术后病理确诊8例。行单纯胆囊切除3例,胆囊癌根治术6例,2例行姑息性手术。术后获随访9例(81.8%),其中1例存活已超过5年,目前仍健在;2例存活超过2年;3例存活超过1年;存活1年以内3例,存活时间4～11个月。2例失访。结论意外胆囊癌术前诊断困难,重视高危因素、术中快速冰冻切片检查是意外胆囊癌诊断的重要依据。而尽快实施手术治疗,并力求根治性切除是其治疗原则。

Objective To investigate the diagnosis and treatment of unsuspected gallbladder carcinoma （UGC）. Methods The clinical data of 11 cases of UGC, who were treated in our hospital from January 2005 to December 2009, were retrospectively analyzed. Results Among the 11 cases of UGC, 4 cases were found in open cholecystectomy and 7 cases in laparoscopic cholecysteetomy. 3 cases were diagnosed intraoperatively and 8 cases were diagnosed postoperatively.3 cases received pure choleeystectomy, 6 cases received radical resection, and 2 cases received palliative surgery. 1 case had lived over 5 years.2 cases had lived over 2 years. 3 cases had lived over one year. 3 cases died within one year. 2 cases had lost in the follow-up visit. Conclusion It is difficult to diagnose unsuspected gallbladder carcinoma before operation. High risk factors valued and frozen section examination should be performed for suspected lesions, which contribute a lot to the diagnosis of unsuspected gallbladder carcinoma. Radical resection should be performed immediately when the diagnosis is confirmed.