摘要
目的 :探讨胆囊癌的手术治疗。方法 :5 2例胆囊癌按Nevin分期采用不同手术方法。NevinⅠ期 8例 ,4例行单纯胆囊切除术 ,4例行扩大的胆囊切除术 ;NevinⅡ、Ⅲ、Ⅳ期 19例 ,行扩大胆囊切除术 ;NevinⅤ期 2 5例 ,8例行超扩大胆囊切除术。结果 :随访 41例 ,各组 1、3、5年生存率 :Ⅰ期 8例 ,4例行单纯胆囊切除术 ,生存数分别为 4例、3例和 2例 ,4例行扩大的胆囊切除术均存活 ;Ⅱ、Ⅲ、Ⅳ期 17例 ,行扩大的胆囊切除术生存数分别为 12例、8例和 5例 ;Ⅴ期 8例行超扩大胆囊切除术生存数分别为 4例、3例和 1例 ,行剖腹活检或内外引流的 17例均在 10个月内死亡。结论 :Ⅰ期扩大胆囊切除优于单纯性胆囊切除术 ,Ⅱ、Ⅲ、Ⅳ期应采用扩大胆囊切除术 ,并注意清扫局部淋巴结 ,Ⅴ期在条件许可时采用超扩大胆囊切除术 。
?Objective:To evaluate methods of surgical treatment in carcinoma of gallbladder.Methods:Fifty-two cases of gallbladder carcinoma were operated according to Nevin's classification:8 cases of stage Ⅰ were operated with simple cholecystectomy in 4 and expansile cholecystectomy in 4;19 cases of stage Ⅱ\,Ⅲ\,Ⅳ were operated with expansile cholecystectomy and 25 cases of stage Ⅴ with super-expansile cholecystectomy in 8.Results:In follow-up study of 41 cases for 1\,3\,5 years,the patients in Nevin stage Ⅰ survived after cholecystectomy were 4\,3\,2,respectively after expansile cholecystectomy in 4 were 100%;Patients of Nevin stage Ⅱ\,Ⅲ\,Ⅳ survived after expansile cholecystectomy were 12\,8\,5;Patients of Nevin stage Ⅴ survived after super-expansile cholecystectomy were 4\,3\,1.All 17 cases operated for laparotomy or bile internal or external drainage died in 10 months.Conclusions:In treatment of carcinoma of gallbladder,effect of expansile cholecystectomy is better than that of simple cholecystectomy in Nevin stage Ⅰ.Expansile cholecystectomy with elimination of regional lymph nodes in Nevin stage Ⅱ\,Ⅲ\,Ⅳ and super-expansile cholecystectomy in Nevin stage Ⅴ significantly increase survival rate of patients with carcinoma of gallbladder. 〔
出处
《蚌埠医学院学报》
CAS
2000年第3期171-173,共3页
Journal of Bengbu Medical College
关键词
胆囊肿瘤
肿瘤/外科手术
gallbladder neoplasms
neoplasms/surgery
