晚期胆囊癌的外科治疗(附40例分析)  

Surgical treatment for advanced gallbladder carcinoma

作　　者：陈永标[1] 江艺[1] 张绍庚[1] 吕立志[1] 胡还章[1] 林华[1] 

机构地区：[1]南京军区福州总医院肝胆外科,福建福州350025

出　　处：《中国现代医学杂志》2005年第9期1418-1420,共3页China Journal of Modern Medicine

摘　　要：目的总结晚期胆囊癌外科治疗对患者预后的影响。方法回顾性分析该院1993年1月￣2003年12月间手术治疗并经病理检查确诊的40例晚期胆囊癌患者的临床资料。结果40例患者中,男15例,女25例,男女之比1:1.65。胆囊癌扩大根治术9例,占22.5%(9/40),扩大根治术后存活7个月￣37个月,平均生存期(19.0±7.5)个月,术后1、2和3年生存率分别为55.6%、44.4%、22.2%;行姑息性切除术13例,术后随访9例,存活3￣15个月,平均生存期(7.0±3.2)个月;肿瘤活检加内外引流术18例,术后随访10例,平均生存期(2.8±1.5)个月。晚期胆囊癌扩大根治术后平均生存时间较姑息性切除术组和活检引流术组明显延长(P值分别为0.03、0.002)。结论扩大根治术是提高晚期胆囊癌存活率的关健,对不能根治者行姑息性切除或引流术可延长生存时间和提高生活质量。[Objective]To define the correlation between prognosis and surgical management in patients with advanced gallbladder carcinoma. [Methods] Retrospective study was used to analyze the clinical data after operation of 40 patiens with advanced gallbladder carcinoma from January 1993 to December 2003. [Results] Of the patients, There were 15 males and 25 females, with M:F=1:1.65. 9 cases (22.5%) underwent extended radical cholecystectomy. Follow-up showed that the survival period was between 7 and 37 months, with the average period of existing (19.0±7.5) months; Postoperative 1,2,3-year survival rates of extended radical cholecystectomy were 55.6%, 44.4%, 22.2%. 13 cases received palliative resection. 9 cases were follow-up, the survival period was between 3 and 15 months, with the average period of existing (7.0±3.2) months; Nonresection drainage were performed in other 18 advanced gallbladder carcinoma. 10 cases were follow-up, the average period of existing was (2.8±1.5) months; The average survival period of advanced cases after extended radical cholecystectomy was significantly longer than that of palliative resection and of nonresection drainage (P=0.03?0.002 respectively). [Conclusion] Extended radical cholecystectomy is crucial to enhance survival rate in advanced gallbladder carcinoma. Palliative resection and nonresection drainage could prolong survival time or improve the quality of life among the patiens with advanced gallbladder carcinoma.

关 键 词：胆囊肿瘤 外科手术 预后 

分 类 号：R735.8[医药卫生—肿瘤]