意外胆囊癌的临床诊断和治疗分析  

Diagnosis and treatment of unsuspected gallbladder carcinoma(UGC)

作　　者：王志忠[1] 刘伟[1] 吴海滨[1] 

机构地区：[1]延安市人民医院普外科,陕西延安716000

出　　处：《延安大学学报（医学科学版）》2011年第3期22-23,共2页Journal of Yan'an University:Medical Science Edition

摘　　要：目的探讨意外胆囊癌的诊断和治疗。方法对我院2001-05～2010-05间12例意外胆囊癌的患者资料进行回顾性分析。结果术前诊断慢性结石性胆囊炎症7例,急性结石性胆囊炎症3例,胆囊息肉2例。开腹胆囊切除术1例,腹腔镜胆囊切除术11例。术中冷冻切片证实胆囊癌3例,术后病理确诊9例。行单纯胆囊切除10例,胆囊癌根治术3例,7例二期行胆囊癌根治术。结论意外胆囊癌术前诊断困难,重视高危因素、术中对可疑病例行快速冷冻切片检查是意外胆囊癌能及时诊断的重要条件。而尽快实施手术治疗,并力求根治性切除是其治疗原则。手术治疗是胆囊癌最有效的治疗手段,早期发现、合理治疗为提高胆囊癌患者生存质量的有效措施。Objective To investigate the diagnosis and treatment of unsuspected gallbladder carcinoma.Methods The clinical data of 12 patients with unsuspected gallbladder carcinoma treated in our hospital from May 2001 to May 2010 were retrospectively analyzed.Results 12 cases were found unsuspectedly by operation,of which 1 were found in open holecystectomy and 11 in laparoscopic cholecystectomy although 7 cases were diagnosed as chronic calculus cholecystitis,3 cases diagnosed as acute calculus cholecystitis,2 cases diagnosed as pure chocystolithiasis and 3 cases diagnosed as gallpolyp before operation.3 cases were confirmed as gallbladder carcinoma by frozen section examination during operation And 9 cases pathological examination after operation.9 cases received pure cholecystectomy,3 cases received radical resection immediately and 7 underwent second resection.Conclusion It is difficult to diagnose unsuspected gallbladder carcinoma before operation.High risk factors valued and frozen section examination should be performed for suspected lesions,which contribute a lot to the diagnosis of unsuspected gallbladder carcinoma.Radical resection should be performed immediately once the diagnosis is confirmed.Surgery is the primary therapeutic method for unsuspected gallbladder carcinoma early finding and reasonable therapy are important for enhancing the survival of patients with unsuspected gallbladder carcinoma.

关 键 词：意外胆囊肿瘤 诊断 手术治疗 

分 类 号：R657.4[医药卫生—外科学]