胆囊区肝癌射频治疗联合LC手术安全性评估

Safety and effectiveness of radiofrequency combined with laparoscopic cholecystectomy in management of liver cancer near the gallbladder

目的:探讨胆囊区肝癌射频治疗联合腹腔镜胆囊切除(laparoscopic cholecystectomy,LC)手术安全性及有效性.方法:选取我院2006-01/2011-05,12例胆囊区的肝癌和27例非胆囊区的肝癌,前者行腹腔镜胆囊切除后再行B超引导或直视下射频消融治疗,后者行B超引导射频消融治疗,进行回顾性分析两组患者术前术后的临床资料,住院时间、并发症发生率和总体生存率情况.结果:通过统计分析患者手术前后的肝功能结果发现,两组患者术前、术后肝功能变化差异无统计学意义(均P>0.05),两组患者在住院时间及术后并发症的发生率上差异无统计学意义(均P>0.05),在手术时间上差异有统计学意义(P<0.01),射频后肿瘤的坏死率,胆囊旁组91.7%(11/12),非胆囊旁组86.4%(19/22),随访5年,排除删失数据对结果的影响后发现两组5年生存率差异无统计学意义(P>0.05).结论:对于胆囊区的肝癌,肝癌射频治疗术联合腹腔镜下胆囊切除,有效避免了因射频消融引起的迟发型胆囊坏死穿孔,手术安全,长期随访疗效可靠.

AIM：To assess the safety and effectiveness of radiofrequency in combination with laparoscopic cholecystectomy（LC） in the management of liver cancer near the gallbladder.METHODS：Twelve patients with liver cancer near the gallbladder and 27 patients with liver cancer far from the gallbladder,who were treated at our hospital from January 2006 to May 2011,were included in this retrospective study.Patients with liver cancer near the gallbladder underwent laparoscopic resection of gallbladder before ultrasound-guided radiofrequency ablation（combination group）,while patients with liver cancer far from the gallbladder underwent ultrasoundguided radiofrequency ablation directly（control group）.Preoperative clinical data,postoperative hospital stay,complication rate and overall survival were compared between the two groups.RESULTS：The changes in liver function parameters between before and after surgery had no significant difference between the two groups of patients（all P 0.05）.There were also no statistically significant differences in hospitalization time and incidence of postoperative complications between the two groups（both P 0.05）.The difference in operative time was statistically significant between the two groups（P 0.01）.The tumor necrosis rate after radiofrequency was 91.7%（11/12） in the combination group and 86.4%（19/22） in the latter group.The 5-year survival rate was similar between the two groups（P 0.05）.CONCLUSION：Radiofrequency combined with laparoscopic gallbladder excision is a safe and effective treatment for liver cancer near the gallbladder.