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作 者:朱宏毅[1] 刘颖斌 ZHU Hong-yi;LIU Ying-bin(Department of Biliary-Pancreatic Surgery,Renji Hospital Affliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)
机构地区:[1]上海交通大学医学院附属仁济医院胆胰外科,上海200127
出 处:《中国实用外科杂志》2022年第10期1184-1188,共5页Chinese Journal of Practical Surgery
基 金:国家自然科学基金重点项目(No.91940305);上海市科委基础重点项目(No.20JC1419100)。
摘 要:胆囊癌是胆道系统最常见的恶性肿瘤,早期诊断困难,恶性程度高,易发生转移和复发。以手术为主的综合治疗是改善胆囊癌病人生存的唯一方法,但仍存在若干争议,如T2期是否需要行肝段切除、扩大根治术是否可以延长晚期胆囊癌病人的生存时间、各期胆囊癌淋巴结清扫范围等。结合术中所见、病理学检查等判断胆囊癌的肿瘤分期,并依据分期规范切除范围和淋巴结清扫是提高R0根治切除率的关键,且扩大根治术可以改善晚期病人的预后。Gallbladder carcinoma is the most common malignancy of biliary system. It is difficult to resect because of its difficulties of early diagnosis, high malignancy grade and early metastasis. Surgery-based treatment is the only way to improve the survival of gallbladder cancer. In recent decades,there are still controversies about the treatment of gallbladder cancer, such as whether hepatectomy is necessary in T2 stage,whether extended radical resection can prolong the survival time of patients with advanced gallbladder cancer, the scope of lymph node dissection in various stages of gallbladder cancer and so on. Based on the selection of surgical methods for gallbladder cancer of different stages, we consider that normalization of the resection scope and lymph node dissection are the key to improve the R0 radical resection rate,and extended radical resection can improve the prognosis of patients with advanced gallbladder cancer.
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