射频消融处理胆囊床在T1b期胆囊癌根治性手术中的应用  

Radiofrequency ablation of gallbladder bed in radical surgery for stage Tib gallbladder cancer

作　　者：李国明 孙文兵[2] 柯山[2] 国士刚 Li Guoming;Sun Wenbing;Ke Shan;Guo Shigan(The Second Department of General Surgery,Chaoyang Central Hospital,Chctoyang 122000,Liaoning Prov­ince,China;Department of Hepatobiliary Pancreas and Spleen Surgery,West Campus,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100043,China;Chaoyang Central Hospital,Chaoyang 122000,Liaoning Province,China)

机构地区：[1]朝阳市中心医院普外二科,辽宁朝阳122000 [2]首都医科大学附属北京朝阳医院西院肝胆胰_脾外科,北京100043 [3]朝阳市中心医院,辽宁朝阳122000

出　　处：《中华肝胆外科杂志》2020年第1期44-47,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨射频消融处理胆囊床在T1b期胆囊癌根治性手术中的应用及在不同期手术中的疗效。方法回顾性分析首都医科大学附属北京朝阳医院西院肝胆胰脾外科2011年4月1日至2019年3月31日收治的21例T1b期胆囊癌手术患者的临床资料,将术中冰冻病理确诊的患者纳入同期手术组,术后确诊补做手术及外院切除胆囊后在首都医科大学附属北京朝阳医院西院补充手术患者纳入二期手术组。观察两组患者手术时间、出血量、生存率及生存时间等差异并统计两组患者5年累积生存率及总体生存时间。结果所有患者均完成胆囊癌根治术,其中男性14例,女性7例,年龄26-70(49.0±13.5)岁,无围手术期死亡病例。同期手术组纳入15例,二期手术组纳入6例。同期手术组出血量少于二期手术[(101.3±35.5)ml比(177.0±44.6)ml],差异具有统计学意义(P<0.05)。两组患者手术时间、生存率、生存时间差异均无统计学意义(均P>0.05)。两组患者5年累计生存率56.5%,总体生存时间(79.0±9.3)个月。结论射频消融处理胆囊床在T1b期胆囊癌根治性手术中安全和有效。对于术中难以明确诊断的T1b期胆囊癌,二期手术可获得与同期手术相同的疗效。Objective To study the value of radiofrequency ablation of gallbladder beds in radical surgery for stage Tib gallbladder cancer.Methods A retrospective study was conducted on 21 patients with stage Tib gallbladder cancer treated in the Department of Hepatobiliary Pancreas and Spleen Surgery,West Campus,Beijing Chaoyang Hospital,Capital Medical University,from April 1,2011 to March 31,2019.Patients who were diagnosed with frozen section during operation were included into the surgery group.Patients who were diagnosed postoperatively and underwent radical surgery for the gallbladder carcinoma were included in the secondary surgery group.The differences in surgical time,bleeding volume,survival rate,and survival time between the two groups after regular follow-up were compared,and the 5-year cumulative survival rates and overall survival time of the two groups were calculated.Results All patients underwent radical gallbladder cancer surgery.There were 14 males and 7 females,aged from 26 to 70(49.0±13.5)years.There were no perioperative deaths.There were 15 patients in the operation group,and 6 patients in the secondary surgery group.The bleeding volume of the surgery group was significantly less than the secondary surgery group[(101.3±35.5)ml vs.(177.0±44.6)ml,P<0.05].There were no significant differences in surgical time,survival rate,and survival time between the two groups(all P>0.05).The 5-year cumulative survival rate for the two groups of patients was 56.5%,and the overall survival time was(79.0±9.3)months.Conclusions Radiofrequency ablation of the gallbladder bed was safe and effective in radical surgery of Tib gallbladder cancer.For Tib stage gallbladder cancer,which is difficult to diagnose during surgery,secondary radical surgery achieved the same results as primary radical surgery.

关 键 词：胆囊肿瘤 射频消融 Tib期 胆囊床 

分 类 号：R735[医药卫生—肿瘤]