降低意外胆囊癌发生率的再认识  

Reconsidering the reduction of incidental gallbladder cancer incidence

作　　者：王坚[1] 杨传鑫 WANG Jian;YANG Chuan-xin(Department of Hepatobiliary and Pancreatic Surgery,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院肝胆胰外科,200233

出　　处：《中国实用外科杂志》2023年第11期1248-1250,共3页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(No.82273411)。

摘　　要：意外胆囊癌的本质是术前的漏诊与误诊。以处理胆囊良性疾病的方式处理胆囊恶性疾病,严重违反肿瘤根治原则,也严重影响病人的预后。术前未行充分的影像学评估或评估不仔细,以及无法通过影像学评估发现早期胆囊癌是发生意外胆囊癌的主客观原因。临床医师应从解决主观原因入手,提高防范意识以降低意外胆囊癌的发生率。胆囊良性疾病的规范诊治是预防意外胆囊癌的关键,应认真做好术前评估、严格把握手术指征、选择适宜的手术方式和认真检查术后胆囊标本,最大程度地避免胆囊良性疾病合并胆囊癌的漏诊与误诊,改善病人的预后。The essence of incidental gallbladder cancer(IGBC) lies in preoperative misdiagnosis and missed diagnosis.Treating malignant gallbladder diseases in the same way as benign gallbladder diseases seriously violates the principles of tumor radical cure and significantly affects patients' prognosis.The main objective and subjective reasons for the occurrence of IGBC are insufficient preoperative imaging assessments or inadequate evaluations and the failure to detect early-stage gallbladder cancer through imaging evaluations.Clinicians should start by addressing subjective factors and raising awareness of preventive measures to reduce the incidence of IGBC.Standardized diagnosis and treatment of benign gallbladder diseases are crucial to preventing IGBC.Adequate preoperative evaluation,strict control of surgical indications,selection of appropriate surgical methods,and meticulous examination of postoperative gallbladder specimens are essential to avoid misdiagnosis and missed diagnosis of gallbladder cancer,complicating benign gallbladder diseases and improving patients' prognosis.

关 键 词：意外胆囊癌 胆囊结石 保胆取石 

分 类 号：R735.8[医药卫生—肿瘤]