胆囊疾病与胃癌发病的临床分析

Clinical analysis of gallbladder disease and gastric cancer

目的:探讨胃癌患者并发胆囊疾病的临床情况。方法:回顾我科2008年至2011年收治的524例胃癌患者,统计其胆囊超声检查结果和相应治疗等相关资料。结果:524例胃癌患者中胆囊无疾病365例,有疾病159例,占30.3%,其中慢性结石性胆囊炎51例,占9.7%;慢性胆囊炎伴胆固醇结晶或息肉36例,占6.9%,慢性非结石性胆囊炎62例,占11.8%;胆囊切除10例,占1.9%。上述病例根治性全胃切除22例;根治性远端胃切除49例;根治性近端胃切除23例;姑息性胃空肠吻合术5例;姑息性胃切除6例;剖腹探查3例;胃癌根治术联合胆囊切除术15例;自愿放弃手术或不能耐受手术36例。15例行胃癌根治术联合胆囊切除术。患者术后住院时间最短9d,最长14d,平均12.1d,均恢复良好,无手术相关并发症。结论:胃癌患者中胆囊疾病发生率高,建议胃癌患者常规进行腹部超声检查,如果患者能耐受手术及术中所见情况允许,应尽可能根治胃癌的同时切除胆囊,胃癌根治联合胆囊切除是安全可行的,可提高患者术后的生活质量,避免二次手术带来的痛苦。

Objective：To sum up the clinical condition of patients with both gastric cancer and gallbladder disease.Methods：Clinical pathological data of 524 gastric cancer patients in our department from January 2008 to December2011 were retrospectively reviewed and their gallbladder ultrasound examination results and corresponding treatments were analyzed. Results：In 524 cases of gastric cancer,159 cases complicated by gallbladder disease（30.3%）,including chronic calculous cholecystitis（9.7%）, chronic cholecystitis with cholesterol crystal or polyps（6.9%）,chronic non calculous cholecystitis（11.8%）,and cholecystectomy（1.9%）.These cases underwent radical total gastrectomy（22）,radical distal gastrectomys（49）,radical proximal gastrectomy（23）,palliative gastrojejunostomy（5）,palliative gastrectomy（6）,exploratory laparotomy（3）,radical gastrectomy combined with cholecystectomy（15）,36 cases voluntarily surrendered operation or could not tolerate operation.In the 15 cases of radical gastrectomy combined with cholecystectomy, the postoperative hospital stay was 9～14 days（avevage 12.1 days）. They recovered well without complications related to operation. Conclusion：The patients with gastric cancer have high incidence of gallbladder disease, so routine abdominal ultrasound examination is recommended. They should accept radical gastrectomy combined with simultaneous cholecystectomy. The operation can improve the life quality of patients and avoid twice operation pains.