T2a期胆囊癌联合或不联合肝脏切除治疗的效果分析  

Analysis of therapeutic effect of T2a gallbladder cancer whether combined with liver resection or not

作　　者：吴昕[1] 洪涛[1] 李秉璐[1] 郑朝纪[1] 刘卫[1] 何小东[1] WU Xin;HONG Tao;LI Binglu;ZHENG Chaoji;LIU Wei;HE Xiaodong(Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,P.R.China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院基本外科,北京100730

出　　处：《中国普外基础与临床杂志》2022年第11期1458-1462,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：中国医学科学院临床与转化医学研究专项(项目编号:2022-I2M-C&T-A-004);中央高水平医院临床科研专项(项目编号:2022-PUMCH-A-054)。

摘　　要：目的 比较T2a期胆囊癌联合或不联合肝脏切除治疗的效果。方法 按照制定的纳入和排除标准回顾性收集2016年1月至2021年12月期间北京协和医院收治的T2a期胆囊癌患者的临床病理资料,根据是否接受联合肝脏切除分为联合肝切除组和未联合肝切除组,比较2组患者的基本信息、围术期信息和预后情况。结果 共有58例患者入组本研究,其中男23例,女35例;年龄(64.8±11.1)岁。联合肝切除组43例、未联合肝切除组15例,2组患者的人口学资料、生活方式、起病症状、术前合并疾病、术前肿瘤标志物等基本信息比较差异均无统计学意义(P>0.05)。与联合肝切除组比较,未联合肝切除组患者中接受胆管切除者占比更高(P=0.013)、手术时间更短(P=0.045),2组患者在其他围术期信息方面比较差异均无统计学意义(P>0.05)。共有12例患者术后发生并发症,Clavien-Dindo分级Ⅰ级3例、Ⅱ级8例、Ⅲa级1例,所有患者均经过积极治疗后好转,均顺利出院,无出院后30 d内再次入院患者。58例患者均获得随访,中位随访时间29个月,随访期内47例(81.0%)患者无瘤生存,2例(3.4%)患者带瘤生存,9例(15.5%)患者死亡。联合肝切除组和未联合肝切除组患者的总生存和无病生存情况比较差异均无统计学意义(χ~2=3.418,P=0.064;χ~2=1.543,P=0.214)。结论 从本组病例结果看,对于T2a期胆囊癌患者,联合肝脏切除并不会导致并发症的增加和住院时间的延长,但也未显示出能明显改善患者的预后。Objective To investigate the effect of combined or non-combined liver resection for T2a gallbladder cancer. Methods According to the established inclusion and exclusion criteria, the patients with T2a gallbladder cancer admitted to Peking Union Medical College Hospital from January 2016 to December 2021 were retrospectively collected,then were assigned into combined with liver resection group and non-combined with liver resection group. The general characteristics, perioperative information, and prognosis of the two groups were compared. Results A total of 58 patients were enrolled in this study, including 23 males and 35 females;aged(64.8±11.1) years. There were 43 cases in the combined with liver resection group and 15 cases in the non-combined with liver resection group. There were no statistic differences in the demographic data, lifestyle, onset symptoms, preoperative combined diseases, and preoperative tumor markers between the two groups(P>0.05). Compared with the combined with liver resection group, the proportion of patients received bile duct resection was higher(P=0.013) and the operation time was shorter(P=0.045) in the noncombined with liver resection group. There were no statistic differences in the other perioperative informations between the two groups(P>0.05). A total of 12 patients had postoperative complications, including 3 cases of grade Ⅰ,8 cases of grade Ⅱ, and 1 case of grade Ⅲa by Clavien-Dindo classification. All patients improved after treatment and were discharged smoothly. No patient was readmitted within 30 d after discharge. All 58 patients were followed up with a median follow up time of 29 months. During the follow-up period, there were 47 cases(81.0%) of tumor-free survival, 2cases(3.4%) of survival with tumor, and 9 cases(15.5%) of death. There were no statistic differences in the overall survival and disease-free survival between the two groups by log-rank test(χ~2=3.418, P=0.064;χ~2=1.543, P=0.214). Conclusion From the results of this study, for T2a gallbladder cancer

关 键 词：胆囊癌 T2a分期 手术 预后 

分 类 号：R735.8[医药卫生—肿瘤]