合并胆石症的原发性胆囊癌36例

Analysis of 36 cases of gallbladder carcinoma accompanied by cholelithiasis

目的：探讨提高合并胆石症的原发性胆囊癌疗效的途径。方法：对1990～1997年收治的36例合并胆石症的原发性胆囊癌进行分析。结果：术前B超、多普勒及CT诊断符合率分别为55.6%、62.5%、60.0%。术中漏诊5例，占13.9%。36例手术探查，切除病变胆囊18例，切除率50.0%，其中达到根治性切除12例，根治率33.3%，Ⅱ～Ⅳ期3年、5年生存率54.5%及36.4%，Ⅴ期3年、5年生存率分别为4.0%及0.0%。结论：提高疗效的途径在于早期发现胆囊癌和处理高危病变的胆道结石患者；强调避免术中漏诊对预后的重要性。

Objective:To explore the ways of improving t he therapeutic efficacy for gallbladder carcinoma accompanied by cholelithiasis.Methods:Thirty－six cases of gallbladder carcinoma accompanied by ch olelithiasis were analysed.Results:The correct diagnosis rates of B－ultrasonic，Doppler－ultra sonic and CT were 55.6%,62.5% and 60.0%,respectively.Five cases(13.9%) were m isdia gnosed in operation.All the 36 cases underwent an exploratory operation.Eighteen (50.0%) lesions were resected,and 12(33.3%) radically resected.The 3 year and 5 year survival rates in Ⅱ\,Ⅲ and Ⅳ stage were 54.5% and 36.4%,while in Ⅴ stag e,4.0% and zero.Conclusions:The key to improve therapeutic efficacy is to find gallb ladder carcinoma early and give proper treatment to the cholelithiasis patients with high－risk lesions for carcinoma.To avoid misdiagnosis during operation is very important for prognosis.