原发性胆囊癌的临床诊治分析  

Analysis of the Diagnosis and Treatment of Primary Gallbladder Cancer

作　　者：索宗武[1] 丁钋[1] 赵永捷[1] 

机构地区：[1]天津市人民医院普外科,300120

出　　处：《实用癌症杂志》2004年第2期193-194,共2页The Practical Journal of Cancer

摘　　要：目的　总结原发性胆囊癌的诊治经验 ,探讨其诊断与治疗的有效途径。方法　回顾性分析 1981年 1月～ 2 0 0 2年 8月间收治的 3 6例原发性胆囊癌病例的临床病理资料。结果　 3 6例原发性胆囊癌患者中 ,有胆道病史者 2 5例 ( 69.44 % ) ;术前B超诊断符合率为 65 .3 8% ,CT诊断符合率为 85 .0 0 % ;全部病例均经手术治疗 ,肿瘤切除率为 5 8.3 3 % ;随访率 83 .3 3 % ,NevinⅠ期 2例均生存 5年以上 ,Ⅱ～Ⅳ期患者平均生存 2 2个月 ,Ⅴ期患者平均生存 13个月 ,仅行剖腹探查者平均生存期仅 3个月。结论　提高原发性胆囊癌疗效的关键在于早期诊断 ,手术是治疗胆囊癌的首选方法 ,对有癌变倾向的胆囊病变行预防性切除 。Objective To summarize our experience of the diagnosis and surgical management for primary gallbladder cancer,and search the effective approach of its diagnosis and treatment.Methods A retrospective analysis on clinical pathological data was made for 36 cases with primary gallbladder cancer treated in our hospital from Jan,1981 to Aug,2002.Results 25 of 36(69.44%) patients had the history of gallbladder disease.The accurate rate of B-mode ultrasonography and computer tomography diagnosis was 65.38% and 85.00%.All the patients were subjected to operation.The tumor resection rate was 58.33%; The followed up rate was 83.33%.All the 2 cases of Nevin's Stage Ⅰ have survived more than 5 years,The mean survival date of the cases of Ⅱ～Ⅳcarcinoma was 22 months,and was 13 months of the Nevin Ⅴ patients,and only 3 months of the patients who received a mere laparotomy.Conclusion The cruxes to improve the curative effect of gallbladder cancer is early diagnosis.Surgical is the first approach in the treatment of gallbladder cancer.For the gallbladder with canceration tendency,preventive cholecystectomy is the effective measures.

关 键 词：原发性胆囊癌 早期诊断 危险因素 手术治疗 临床特点 影像学检查 

分 类 号：R735.8[医药卫生—肿瘤]