根治性切除术治疗中晚期胆囊癌远期疗效分析

The long term effect analysis for radical cholecystectomy in the treatment of middle-late stage gallbladder cancer

目的探讨中晚期胆囊癌根治性切除术治疗的远期疗效。方法回顾性分析该院73例中晚期胆囊癌患者的临床资料,分别采用非手术治疗、姑息性手术、单纯胆囊切除术、胆囊癌根治术、胆囊癌扩大根治术。结果73例胆囊癌患者中,1年生存率60.27%(44/73),3年生存率32.88%(24/73),3年生存率19.18%(24/73);随着Nevin分期的增加,患者平均生存时间、生存率均明显下降;Ⅰ-Ⅱ期、淋巴结无转移、肿瘤浅肌层浸润、切除治疗生存率明显高于Ⅲ-Ⅴ、淋巴结有转移、肿瘤深肌层浸润、姑息治疗(P<0.05、0.01);Nevin分期、淋巴结转移程度、肿瘤浸润程度是影响胆囊癌远期疗效的主要因素。结论应根据胆囊癌病理分期,采取以根治术为主的综合治疗方式,以期获得更好的临床预后。

[ Objective ] To study long term effect of radical cholecystectomy in the treatment of middle-late stage gallbladder cancer. [ Methods ] The clinical data of 73 patients with middle-late stage gallbladder under nonsurgical, palliative surgery, gallbladder radical choleeysteetomy ,gallbladder enlarge radical resection treatment were retrospectively analyzed. [ Results ] 73 patients with gallbladder cancer, 1 year survival rate was 60.27% （44/73）, 3 year survival rate was 32.88% （24/73）, 3 year survival rate was 19.18% （24/73）;. With the increase of Nevin stage, the average survival time and survival rate were significantly decreased; I - II period, without lymph node metastasis, tumor excision with shallow muscular infiltration, the survival rate was significantly higher than III - V, lymph nodes with metastasis, tumor deep muscularis infiltration, palliative care （P 〈 0.05, 0.01）; Nevin stage, lymph node metastasis, tumor infiltration degree were main factors influencing of gallbladder cancer forward curative effect. [ Conclusion ] According to the gallbladder pathological stage, radical eholeeystectomy of comprehensive treatment can get better clinical prognosis.