联合肝叶和部分胰头、十二指肠切除治疗NevinⅤ期胆囊癌临床体会  

Clinical experience for surgical treatment of Nevin's stage Ⅴ gallbladder carcinoma combined with the lobe of the liver and pancreas duodenum partial resection

作　　者：董满库[1] 姜福全[1] 李晓鸥[1] 孙宏伟[1] 胡刚[1] 吉敏[1] 杨建武[1] 王平[1] 李成林[1] 张宏文[1] 崔彥 

机构地区：[1]解放军第306医院普通外科中心,北京100101

出　　处：《川北医学院学报》2015年第3期310-313,共4页Journal of North Sichuan Medical College

基　　金：全军医学科研"十二五"重点项目(BWS11J051)

摘　　要：目的:总结NevinⅤ期胆囊癌的外科治疗经验,探讨胆囊癌侵犯周围脏器后的手术方式(肝叶切除+胰十二指肠部分切除)和根治性切除的可行性。方法:回顾性分析2000年1月至2014年1月间,经手术治疗并有病理诊断的8例NevinⅤ期胆囊癌患者的临床资料。结果:8例患者均顺利完成手术,其中1例术后1周死于急性肾功能衰竭,1例仅生存9个月,其余6例生存超过2年,无生存超过3年病例。结论:对部分伴有十二指肠和胰头前方受侵犯的胆囊癌患者,特别是起源于胆囊体底部的NevinⅤ期胆囊癌患者,如无明显远处转移,患者全身情况能够耐受手术,应积极行手术探查,联合肝叶及胰十二指肠部分切除治疗是一种确实可行的手术方式,可提高患者的生存质量,延长生存期,并减少术后并发症。Objective：To summarize the experience of surgical treatment of gallbladder carcinoma in Nevin’ s stage V and to explore the gallbladder carcinoma invading the adjacent organs after the operation mode （ Hepatic lobectomy and partial pancreatoduo-denectomy） and the feasibility of radical resection. Methods：A retrospective analysis from January 2000 to January 2014,clinical data and pathological diagnosis after surgical treatment of 8 cases of Nevin’ s stage V gallbladder cancer patients. Results：8 patients were successfully completed the operation,including 1 cases of postoperative 1 weeks died of acute renal failure,1 cases only survived 9 months,the remaining 6 cases survived more than 2 years,no survival for more than 3 years cases. Conclusion：On the part of the duo-denum and the head of the pancreas with front against violations of the gallbladder cancer patients,especially in patients with Nevin’ s stage V gallbladder cancer originated in the bottom of the gallbladder body,such as no obvious metastasis,general condition of the pa-tients can tolerate the operation,we should actively explore the operation,combined with the hepatic lobectomy and partial pancreatodu-odenectomy is a really feasible operation mode which can improve the life quality of patients,prolong the survival period,and reduce the postoperative complications.

关 键 词：胆囊肿瘤 根治性切除术 肝叶切除 胰十二指肠部分切除 

分 类 号：R735.8[医药卫生—肿瘤] R615[医药卫生—临床医学]