意外胆囊癌外科治疗进展与争议  

Advance and controversy on surgical treatment of incidental gallbladder carcinoma

作　　者：刘伟[1] 王亚军[1] 王永兴[1] Liu Wei;Wang Yajun;Wang Yongxing(Department of General Surgery,the 969th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army,Hohhot 010051,China)

机构地区：[1]中国人民解放军联勤保障部队第九六九医院普通外科,呼和浩特010051

出　　处：《中华普通外科学文献（电子版）》2022年第6期448-451,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：胆囊癌早期缺乏特异性的临床表现、生物学指标及影像特征,故临床极易出现漏诊。针对存在胆囊癌高危因素的患者,在早期采取适宜、必要的检查手段有助于提高意外胆囊癌的检出率。根治性手术是T1b-T3期意外胆囊癌最有效的治疗方法,但对于不同肿瘤分期手术切除范围、手术方式及二次手术时机、是否常规切除戳孔等尚存在较大争议。腹腔镜技术仅限于早期患者的探索性研究,对于进展期意外胆囊癌患者仍建议开腹手术。Incidental gallbladder carcinoma is probably misdiagnosed at early stage due to the lack of unique clinical symptoms,biochemistry and imaging features.Appropriate and essential examinations can improve the preoperative diagnosis rate for patients with high risk of gallbladder carcinoma in clinical practice.Radical resection is considered as the most effective procedure for incidental gallbladder carcinoma with T1b-T3 diseases because of the superior survival,but there remains some controversies about the scope of resection according to different tumor stages,the types of surgical access,the timing of reoperation and whether to remove the port-site routinely.Open surgery is recommended in cases of advanced gallbladder carcinoma,and laparoscopic procedure is just suggested for exploratory study in patients at early stage.

关 键 词：意外胆囊癌 开放手术 腹腔镜 胆囊癌根治术 戳孔转移 

分 类 号：R735.8[医药卫生—肿瘤]