摘要
目的探讨腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)中有效诊治意外胆囊癌(unsus-pectedgallbladdercarcinoma,UGC)的方法。方法回顾分析了1330例腹腔镜胆囊切除术中5例意外胆囊癌的临床资料。结果术中有128例怀疑为胆囊癌而行冰冻切片检查,有4例被诊断为胆囊癌。1例Ⅲ期,放弃治疗,3个月后死亡。2例Ⅱ期胆囊癌病人中转开腹行根治术后分别于25和13个月后死亡。1例Ⅲ期胆囊癌病人中转开腹行根治术后8个月死亡。在余下的1203例中,1例术后病理检查诊断为胆囊癌Ⅰ期,随访3a,仍存活。结论胆囊癌存活期短,预后差。腹腔镜术中仔细操作是减少切口转移的关键。及时根治是切除延长UGC患者术后生存期的有效手段。
[Objective] To explore the diagnosis and treatment of unsuspected gallbladder carcinoma（UGC） during operating laparoscopic cholecystectomy（LC）. [Methods] The clinical data of 5 cases with UGC in 1 330 cases with LC was reviewed retrospectively. [Results] Intraoperatively in 128 cases there was the suspicion of adenocarcinoma and frozen sections were performed. In four of them the diagnosis of adenocareinoma was confirmed. One with stage Ⅲ refused reoperation, In three of them the procedure was converted to open with radical surgery. Two with stage Ⅱ died in 25 months and 13 months respectively. One with stageⅢ died in 8 months. Of the remaining 1 203 patients, one was diagnosed postoperatively at the pathologic examination. He was peformed by LC alone three years ago, is alive to date. [Conclusion] Gallbladder cancer runs a short course, with a poor prognosis. The use of a meticulous laparoscopic technique seems to be important for the avoidance of port site metastases（PSM）. It is an effective way to choose timely a second or converted open radical surery for prolonging the survival of the UGC.
出处
《中国内镜杂志》
CSCD
北大核心
2005年第11期1201-1202,1206,共3页
China Journal of Endoscopy
关键词
胆囊肿瘤
胆囊切除术
腹腔镜
gallbladder neoplasm
cholecystectomy
lapamscopy
