胆囊切除后的结肠癌:附25例报告

Colonic cancer occurred after cholecystectomy:a report of 25 cases

目的 总结胆囊切除术后结肠癌的诊疗经验 ,借以探讨结肠癌与胆囊手术的关系。方法 回顾分析 2 5例胆囊切除术后结肠癌的临床资料。结果 2 5例的发病时间分别是 10年者 3例(12 .0 % ) ,12年以上者 2 2例 (88.0 % )。 2 5例中 6例有家族癌症史 (2 4.0 % ) ,5例有结肠息肉 (2 0 .0 % ) ,2例有结肠腺瘤 (8.0 % )。肿瘤位于盲肠 10例 (4 0 .0 % ) ,升结肠 7例 (2 8.0 % ) ,横结肠 3例(12 .0 % ) ,降结肠 3例 (12 .0 % ) ,乙状结肠 2例 (8.0 % )。全部病人经手术治疗 ,其中根治性手术 18例 ,姑息性手术 7例 ,术后均顺利恢复出院。结论 加强胆囊切除术后患者的定期随访对早期发现结肠癌是很有必要的。

Objective To summarize the diagnosis and treatment of 25 cases of colonic cancer occurred after cholecystectomy ,and to explore the correlation between colonic cancer and cholecystectomy. Methods The clinical data of the 25 cases were retrospectively analysed. Results The onset time of the cancer was 10 years after cholecystectomy in 3 cases(12%) and over 12 years in 22 cases(88%). Six cases had family history of canceration(24%), 5 had colonic polyps(20%) and 2 had colonic adenoma (8%). Tumor located in appendix in 10 cases (40%),in ascending colonic in 7 cases (28%),in transverse colonic in 3 cases(12%),in descending colonic in 3 cases (12%) and in sigmoid colonic in 2 cases (8%). Eighteen patients underwent radical operation (72%),and 7 had palliative operation (28%). All patients recovered successfully after the operation. Conclusions Periodical postoperative follow up of the patients after cholecystectomy is an effective method to discover colonic cancer in early stage.