原发性胆囊癌诊治的若干问题探讨  

Several important issues on diagnosis and treatment of primary gallblad-der carcinoma

作　　者：刘晓平[1] 李宝金[1] 王少发[1] 叶建宇[1] 周晓初[1] 龙光辉[1] 彭毅[1] 

机构地区：[1]北京大学深圳医院,广东深圳518036

出　　处：《罕少疾病杂志》2005年第4期18-20,23,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨原发性胆囊癌的诊断与手术治疗。方法回顾性分析19例胆囊癌患者的临床资料,并结合有关文献分析原发性胆囊癌(PGC)的高危因素及诊治特点、意外性胆囊癌(UGC)及针孔切口种植转移(PSM)。结果本组合并胆囊结石12例,占63.16%(12/19),术前确诊率为63.16%(12/19),联合B超及CT的诊断符合率91.67%(11/12),手术切除率47.37%(9/19)。腹腔镜胆囊切除术(LC)后UGC发生率0.11(%2/1866),常规剖腹胆囊切除术(OC)后UGC发生率0.26%(1/383),总UGC发生率为0.13%(3/2249),LC术后PSM发生率0.05%(1/1866)。定期随访3个月至5年不等,平均生存时间为2.4年。结论B型超声联合CT是术前较有效的诊断方法,防止UGC漏诊的有效方法是术中常规胆囊冰冻病理及全胆囊病理检查,治疗首选胆囊癌根治术。Objective To explore the diagnosis and surgical treatment of primary gallbladder carcinoma （PGC）. Methods By way of the retrospective clinical analysis of 19 cases of PGC, some details combined with related literature were construed involving high dangerous factor, clinical characteristic, unexpected gallbladder carcinoma （UGC） and port site metastasis（PSM） about PGC. Results Twelve cases with gallbladder stone （63.16%） in the group：12 cases of PGC were confirmed according to clinical behave, computed tomography （CT）and B-ultrasonography （B-US）. Preoperative diagnostic rate were 63.16% （12/19）, operative resection rate were 47.37% （9/19）. Two cases of UGC encountered during 1866 cases of laparoscopic cholecystectomy （LC） （0.11%）; one of 383 cases with open cholecystectomy（OC） （0.26%）, and overall rate of UGC of LC and OC were 0.13% （3/2249）. one of PSM during 1866 cases of LC （0.05%） were observed. Following-up for three months to five years, the average survival time were 2.4 years. Conclusion B-US and CT arc the main methods in early diagnosis of PGC. The entirely resected gallbladder should be routinely examined and frozen-section examination in order to avoid pretermission. Once PGC is diagnosed, radical resection is the best choice.

关 键 词：胆囊肿瘤 针孔切口种植转移 意外胆囊癌 诊断 治疗 

分 类 号：R735.8[医药卫生—肿瘤] R657.4[医药卫生—临床医学]