胆囊癌根治术淋巴结清扫范围及意义

Significance and the scope of lymph node dissection for gallbladder cancer curative surgery

淋巴结转移是胆囊癌常见的转移方式,也是导致胆囊癌病人预后不良最主要的原因之一。对于可切除的胆囊癌而言,根治性外科手术是目前唯一可能治愈该疾病的手段,并可以显著改善预后,其治疗效果与淋巴结转移的远近及数量直接相关。随着对胆囊癌淋巴结转移的不断认识,学术界对淋巴结清扫的范围、数量仍存在较大的争议。如何通过术前评估、术中探查明确胆囊癌淋巴结清扫的范围,是保证病人最小创伤的同时达到R0切除的关键。此外,通过淋巴结清扫还可以明确胆囊癌分期,进而帮助医生综合判断病人预后,提出术后综合治疗方案,使病人获得更好的受益。

Lymph node metastasis is a common way for gallbladder cancer to spread,which is also one of the main reasons for the poor prognosis of patients with gallbladder cancer.For resectable gallbladder cancer,curative surgery is currently the only possible means to cure the disease and can significantly improve prognosis.The treatment effect is directly related to the distance and number of lymph node metastases.With continuous understanding of lymph node metastasis in gallbladder cancer,there is still significant controversy in the academic community regarding the scope and number of lymph node dissection.To determine the scope of lymph node dissection for gallbladder cancer through preoperative evaluation and intraoperative exploration is the key to ensuring minimal trauma to the patient while achieving R0 resection.In addition,lymph node dissection can also clarify the staging of gallbladder cancer,which can help doctors comprehensively assess the patient's prognosis,propose postoperative comprehensive treatment plans,and maximize the patient's benefits.