摘要
目的探讨在腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)中意外发现的胆囊癌的治疗方法。方法对17例LC时意外发现的胆囊癌者的临床资料进行回顾性分析。结果11例NevinI,II期患者行单纯LC;1例III期和3例V期患者行LC+局部淋巴结清扫术;2例IV期患者行胆囊切除术。全组意外胆囊癌的发生率为0.6%。I,II期患者术后最长随访5年,未见复发;III期1例术后1.5年复发,再次手术;而IV,V期的病例预后较差,均于1年内死亡。结论I,II期的意外胆囊癌行LC可达到根治目的。III期的需行胆囊癌根治术,如术中做到切缘镜下无瘤可望提高生存率。V期应采用局部清扫+肝脏楔形切除术进行治疗。
Objective To explore the treatment of incidental gallbladder carcinoma （UGC）discovered during laparoscopic cholecystectomy （LC）. Methods The clinical data of 17 cases of incidental gallbladder carcinoma discovered during laparoscopic cbolecystectomy were reviewed retrospectively, Results 11 cases with Nevin stage Ⅰ or stage Ⅱ were treated by LC and 1 case with Nevin stage Ⅲ and 3 cases with Nevin stage V were treated by LC and radical local lymphadeneetomy. 2 cases with Nevin stage Ⅳ were treated by cholecystectomy. UGC was incidently found in 0. 6 % of the cases, Cases with Nevin Stage Ⅰ and Ⅱ were observed for 5 years with no recurrence, A case with Nevin Stage Ⅲ was found to have recurrence within one and a half years postoperatively and had a re- operation. The prognosis of patients with Nevin Stage Ⅳ and Ⅴ was poor and they were dead within a year after operation. Conclusions The incidently found gallbladder carcinoma with Nevin Stage Ⅰ and Ⅱ disease can be radically resected with laparoscopic cholecystectomy. The incidently found gallbladder carcinoma with Nevin Stage Ⅲ and Ⅳ disease needs to be radically resected , and if the resection margin is found to be free of tumour, the prognosis is enhanced, The ones with Nevin Stage Ⅴ need to be treated by local lymphadenectomy and wedge- resection of liver.
出处
《中国普通外科杂志》
CAS
CSCD
2005年第8期570-572,共3页
China Journal of General Surgery
