腹腔镜胆囊切除术后意外胆囊癌相关因素分析

目的探讨腹腔镜胆囊切除术后意外胆囊癌的总发生率、相关危险因素及影响总生存率的相关因素。方法回顾性分析医院普外科2016年6月至2020年6月收治的意外胆囊癌并完成根治性胆囊切除术患者的资料。分析患者一般资料、术中发现、原发手术的组织病理学、两次手术的中间间隔时间,以寻找与意外胆囊癌相关的各种因素和影响总生存率的因素。结果意外胆囊癌发病率为0.51%,男女比例为1∶3,平均年龄67.3岁;术前影像均提示慢性胆囊炎及多发性胆囊结石;其中1例并胆总管结石;病理组织学检查均为腺癌;病理分期7例为pT1b,1例为pT2;胆囊切除术与完全根治性胆囊切除术的中间间隔时间平均为6.8 d;所有病例均存活。结论意外胆囊癌以老年女性居多,其危险因素与多发性胆囊结石、单发大石头、再次手术间隔时间及病理分期晚有关。

Objective To investigate the total incidence,related risk factors and related factors affecting the overall survival rate of unexpected gallbladder cancer after laparoscopic cholecystectomy.Methods The data of patients with unexpected gallbladder cancer who had undergone radical cholecystectomy from June 2016 to June 2020 were retrospectively analyzed.The general data of patients,intraoperative findings,histopathology of primary operation,and median interval between two operations were analyzed to find out various factors related to unexpected gallbladder cancer and factors affecting overall survival rate.Results The incidence rate of unexpected gallbladder cancer was 0.51%,the ratio of male to female was 1∶3,and the average age was 67.3 years old.Preoperative imaging showed chronic cholecystitis and multiple gallstones,including 1 cases with choledocholithiasis.Histopathological examination showed all of them were adenocarcinoma,7 cases of pathological stage pT1b and 1 cases of pT2.The median interval between cholecystectomy and radical cholecystectomy was 6.8 d.All cases survived.Conclusion The majority of accidental gallbladder cancer is elderly women,and its risk factors are related to multiple gallstones,single large stones,interval of re-operation and late pathological stage.