原发性进展期胆囊癌肝转移的临床病理与手术方式的选择  

Clinicopathological features and surgical management of liver metastasis of progressive gallbladder carcinoma

作　　者：周正[1] 项灿宏[1] 贾振庚[1] 潘瑞芹[1] 吉川达也[1] 

机构地区：[1]中日友好医院普外科,北京市100029

出　　处：《中华肝胆外科杂志》2002年第8期478-481,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　本文依据进展期胆囊癌肝转移的临床病理学特点 ,探讨其手术方式。方法　对1 63例手术切除的原发性进展期胆囊癌进行临床病理学研究 ,并对原发癌的临床病理学诸因子与肝转移的关系进行了分析。结果　胆囊癌侵及肝脏达 2 0mm以上 ,癌已侵达胆囊浆膜外或已侵及周围脏器 ,主癌灶位于胆囊肝床侧或已侵及胆囊全周 ,高度的静脉、淋巴管浸润是胆囊癌肝转移的 5个高危因素 ;胆囊癌有转移至第 4、5肝段的倾向 (61 5 % ) ,这种倾向在早期的肝转移时更为明显 (92 % )。结论　应根据肝转移的高危因素及转移灶的分布特点 ,合理地选择肝床切除、肝段切除、肝切除 +肝动脉插管化疗等手术方式。Objective To analyze the clinicopathological features of liver metastasis of progressive gallbladder carcinoma and discuss its surgical management. Methods A retrospective clinicopathological study was conducted on 163 patients receiving surgical resection of primary progressive gallbladder carcinoma. Meanwhile, the relationship between clinicopathological factors and hepatic metastasis was determined. Results The 5 high risk factors for hepatic metastasis were: 1) hinf3;2) se and si carcinoma;3) the location of the lesion on hep/circ;4) ly3;5) v3. More than half of the metastases were located in segment 4 and 5 (61 5%). Conclusions Appropriate surgical management can be chosen according to the high risk factors of hepatic metastases and the distributive characteristics of the metastatic lesions.

关 键 词：原发性进展期 病理 手术方式 胆囊肿瘤 肿瘤转移 

分 类 号：R735.7[医药卫生—肿瘤]