意外早期胆囊癌的手术治疗与预后分析  

Surgical treatment and prognosis of early stage unexpected gallbladder carcinoma

作　　者：陈飞 李炜[2] 韩峰[2] 

机构地区：[1]通州市中医院普外科,江苏南通226300 [2]上海中医药大学附属普陀医院普外科,上海200062

出　　处：《肝胆胰外科杂志》2010年第2期107-109,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨意外发现的早期胆囊癌的治疗方法与预后。方法回顾性总结1995年7月至2005年7月我院收治的24例意外早期胆囊癌临床病理资料,对其治疗方法及影响预后的因素进行分析。结果24例术中快速冰冻切片或术后病理切片证实为早期胆囊癌(NevinⅠ～Ⅱ期)。7例于术中施行了标准的根治术,10例术后确诊再行根治,7例行单纯胆囊切除术。多因素分析表明,组织学分级、Nevin分期及手术方式是影响预后的独立因素;再次行根治手术组生存率与即刻行根治手术组比较无统计学差异,单纯胆囊切除术组与胆囊癌根治术组患者的生存率差异有统计学意义。结论早期胆囊癌术前诊断困难,术中对可疑者做快速冰冻切片检查有助于发现早期胆囊癌;一旦确诊即予施行根治术,术后病理明确者亦应再行根治手术。Objective To explore the surgical treatment and prognosis of early stage unexpected gallbladder carcinoma.Methods The clinical and pathological data of 24 patients with early stage gallbladder carcinoma treated in our hospital from July 1995 to July 2005 were retrospectively summarized,in which different treatment and factors affecting prognosis were analyzed.Results All the 24 cases were confirmed as early stage gallbladder carcinoma（Nevin Ⅰ～Ⅱ stage） by frozen section examination during operation or pathological examination after operation.Seven cases received radical resection immediately,10 underwent second radical resection when the diagnosis was confirmed,and 7 cases only received simple cholecystectomy.Multivariate analysis showed that histological differentiation,Nevin stage and surgical methods were the independent factors for prognosis of early stage unexpected gallbladder carcinoma.There was no significant difference in the survival rate between patients who received radical resection immediately and those who received radical resection in the second operation;but significant difference was observed between patients who received radical resection and those who not.Conclusion It is difficult to diagnose the early stage gallbladder carcinoma before operation.Frozen section examination should be performed for the suspected lesions,which contributes a lot to the early diagnosis of unexpected gallbladder carcinoma.Radical resection should be performed once the diagnosis is confirmed by pathological evidence,whenever during operation or after operation.

关 键 词：意外早期胆囊癌 手术治疗 预后 

分 类 号：R735.8[医药卫生—肿瘤]