胆囊癌453例患者临床分析  

Clinical analysis of 453 cases of gallbladder carcinoma

作　　者：李杰[1] 徐心[1] 唐楷杰 阎堃[1] 王志亮[1] 

机构地区：[1]西安交通大学医学部第二附属医院普通外科,西安710004

出　　处：《山西医科大学学报》2016年第2期164-166,共3页Journal of Shanxi Medical University

基　　金：国家自然科学基金资助项目(81172358)

摘　　要：目的总结我院胆囊癌的诊治经验。方法分析我院1991-2010年间共计453例胆囊癌患者的临床资料、肿瘤分期、手术方式及生存状况。结果术前确诊330例(72.85%);未予确诊123例:术中冰冻切片确诊55例,术后病理切片证实38例,经皮肝穿刺胆道引流术(PTCD)或内窥镜逆行胰胆管造影(ERCP)治疗中确诊30例。344例行手术治疗,48例未手术,61例行PTCD或ERCP放置支架及外引流。随访344例手术患者:其中1月生存率87.50%(301/344),3月生存率65.99%(227/344),1年生存率51.74%(178/344),3年生存率17.15%(59/344),5年生存率5.81%(20/344)。胆囊癌TNMⅠ期患者行单纯胆囊切除术,Ⅱ期行胆囊癌根治术,5年生存率分别100%和50%。结论对胆囊癌患者进行合理、科学的TNM分期,制定前瞻性的手术方案,可延长患者生存时间。Objective To summarize the diagnosis and treatment of gallbladder carcinoma. Methods Data of 453 cases suffering from gallbladder carcinoma in our hospital in 1991- 2010 were collected and analyzed,including clinical data,diagnosis of tumor staging,surgical approaches,and survival rate. Results The rate of preoperative diagnosis was 72. 85%（ 330 /453）. In the other 123 cases,55 cases were diagnosed by frozen section during the surgery,38 cases by postoperative pathologic examination,and 30 cases by percutaneous transhepatic cholangial drainage（ PTCD） or endoscopic retrograde cholangiopancreatography（ ERCP）. As to the therapy,61 cases were performed by PTCD or ERCP,48 cases were not operated because of the late stage,and other 344 cases were operated by surgery and followed up. The 1-month survival rate was 87. 50%（ 301 /344）,3-month survival rate was 65. 99%（ 227 /344）,1-year survival rate was51. 74%（ 178 /344）,3-year survival rate was 17. 15%（ 59 /344）,and 5-year survival rate was 5. 81%（ 20 /344）. The 5-year survival rate was 100% for stageⅠafter simple cholecystectomy and 50% for stageⅡafter extended cholecystectomy. Conclusion Gallbladder carcinoma should be staged exactly to guide the appropriate and forecasting surgical approaches,which will benefit patients＇ survival.

关 键 词：胆囊癌 TNM分期 手术方式 生存率 

分 类 号：R735.8[医药卫生—肿瘤]