胆囊癌侵犯胆管导致阻塞性黄疸手术治疗效果分析  

Surgical treatment of obstructive jaundice induced by biliary invasion in patients with gallbladder cancer:an analysis of outcome in 48 cases

作　　者：冯飞灵[1] 刘辰[1] 谭蔚锋[1] 邱应和[1] 易滨[1] 姜小清[1] 

机构地区：[1]第二军医大学东方肝胆外科医院胆道一科,上海200438

出　　处：《第二军医大学学报》2010年第8期857-860,共4页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(30872507)~~

摘　　要：目的探讨胆囊癌侵犯胆管导致阻塞性黄疸患者采用手术治疗的效果。方法回顾性分析我院2004年1月至2008年12月48例胆囊癌侵犯胆管导致阻塞性黄疸患者的临床资料并进行随访。结果 48例患者分为手术治疗36例,非手术治疗12例,生存时间分别为(17.39±3.98)、(3.75±0.51)个月,差异具有统计学意义(P<0.01);手术治疗患者中接受R0切除15例,R1切除7例,R2切除14例,R0、R1、R2切除的生存时间分别为(30.93±7.42)、(13.57±6.70)、(5.00±0.67)个月,三者间差异有统计学意义(P<0.01)。结论胆囊癌伴阻塞性黄疸患者预后较差,但外科手术治疗能部分改善单纯因胆囊侵犯胆管导致阻塞性黄疸患者的预后,对此类患者应当尽量行根治切除术,必要时还需行扩大根治术。Objective To analyze the outcomes of surgical treatment of obstructive jaundice induced by biliary invasion in patients with gallbladder carcinoma.Methods We retrospectively analyzed the clinical data of 48 patients with gallbladder cancer and biliary invasion-induced obstructive jaundice,who were treated in our hospital during January 2004 to December 2008.Results Thirty-six patients who received surgical treatment had a median survival time of（17.39±3.98） months,and 12 patients received non-surgical treatment had a median survival time（3.75±0.51） months,with significant difference found between the two groups（P0.01）.Fifteen patients underwent radical resection,7 underwent R1 resection,and 14 underwent R2 resection,with their median survival time being（30.93±7.42） months,（13.57±6.70） months,and（5.00±0.67） months,respectively;there were significant difference between the three groups（P0.01）.Conclusion The prognosis of gallbladder cancer with obstructive jaundice is poor;surgical treatment can partly improve the prognosis of patients with obstructive jaundice-induced by gallbladder invasion.Radical curative resection,sometime with cholecystectomy,partial hepatectomy,or bile duct resection,should be performed for these patients.

关 键 词：胆囊肿瘤 阻塞性黄疸 胆管侵犯 根治术 

分 类 号：R735.8[医药卫生—肿瘤]