腹腔镜胆囊切除意外胆囊癌的处理策略  

Management of incidental gallbladder cancer discovered during or after laparoscopic cholecystectomy

作　　者：刘桂杰[1] 李学华[1] 赵贵美[1] 孙会东[1] 张金良[1] 胡三元[2] 

机构地区：[1]聊城市人民医院,泰山医学院聊城临床学院,山东聊城252000 [2]山东大学齐鲁医院

出　　处：《腹腔镜外科杂志》2013年第12期931-934,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨不同处理方式对腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后意外胆囊癌(incidental gallbladder cancer,IGBCA)预后的影响。方法:回顾分析LC术后22例IGBCA患者的临床资料。结果:根治性手术患者15例,3年生存率46.67%,5年生存率26.67%;姑息性手术患者7例,3年生存率14.29%,5年生存率为0。根治性手术患者生存时间明显长于姑息性手术患者,平均生存时间(56.19±6.61)个月vs.(26.20±5.19)个月(χ2=5.290,P=0.021)。结论:LC术前应警惕IGBCA的发生,根治手术患者的预后明显优于姑息性单纯胆囊切除的患者,经过合理的再次根治手术,LC并不影响IGBCA患者的预后。Objective ： To evaluate the impact of different treatment on the prognosis of incidental gallbladder cancer （IGBCA） discovered during or after laparoseopie cholecysteetomy （LC）. Methods： A retrospective clinicopathologic study was performed on 22 patients with IGBCA that discovered during or after LC. Results：Fifteen cases received radical resection,with a 3-year survival rate of 46.67% and 5-year survival rate of 26.67% ;7 cases underwent palliative laparoseopic eholecysteetomy,with a 3-year survival rate of 14.29% and 5-year survival rate of 0. The survival time of radical resection patients was significantly better than that of palliative resection ones,the mean survival time was （56.19 ±6.61 ） months vs. （ 26.20 ±5.19 ） months （ χ^^2 = 0. 741, P = 0. 021 ）. Conclusions ： Surgeons should keep vigilant over the occurrence of IGBCA before doing LC. The prognosis of radical resection patients is significantly better than that of palliative resection ones. LC does not worsen the prognosis of IGBCA if second radical resection is implemented properly.

关 键 词：胆囊切除术 腹腔镜 胆囊肿瘤 意外胆囊癌 预后 

分 类 号：R735.8[医药卫生—肿瘤]