摘要
目的 探讨意外胆囊癌再手术的治疗效果。方法 对1995年1月至2002年12月期间15例胆囊切除术后发现的意外胆囊癌再手术治疗进行回顾性总结。结果 15例意外胆囊癌(pT211例,pT3 4例)中,12例再次行根治性胆囊床肝楔形切除加淋巴结清扫,再手术时间(17.3±6.2)d;3例行姑息性手术,再手术时间(49±12.5)d。术后发现淋巴结转移2例(pT2 1例,pT3 1例),肝转移2例(pT2 1例,pT3 1例),腹腔种植(pT3)及广泛转移(pT2)各1例。3例行姑息性手术者生存3-5个月,12例根治性术后生存期明显延长(25.75±4.89)个月。结论 胆囊切除术后发现意外胆囊癌(pT2／T3)需及时积极再次剖腹作根治性手术,以改善病人的预后和延长生命。
<abstract>jective To investigate the effect of the second resection for unsuspected gallbladder carcinoma discovered after cholecystectomy. Methods A retrospective clinicopathological analysis was conducted for 15 cases of unsuspected gallbladder carcinoma receiving the second operation in our hospital from January 1995 to December 2002. Results Of the 15 patients with unsuspected gallbladder carcinoma (11pT2 , 4pT3), 12 received second radical resection of the liver bed with lymph dissection and the time of the second operation was 17. 3 ± 6. 2 d after cholecystectomy, and the other 3 received palliative operation and the time was 49±12. 5 d after cholecystectomy. Amongst the 15 patients, 2 developed lymph metastasis (1pTs, 1pT3), 2 liver metastasis (1pT2, 1pT3), 1 (pT3) parietal seeding and 1 distant metastasis (pT2) after the operations. The 3 patients receiving the palliative operation died in 3-5 months and the 12 receiving the radical operation achieved long-term survival (25. 75±4. 89 months) after the operations. Conclusions The radical resection for unsuspected gallbladder carcinoma discovered after cholecystectomy may help in making the prognosis better and extending the survival time.
出处
《中华肝胆外科杂志》
CAS
CSCD
2004年第7期447-449,共3页
Chinese Journal of Hepatobiliary Surgery
