摘要
目的了解目前意外胆囊癌术前诊断方法和治疗方案的研究进展。方法检索近年来国内外关于胆囊癌、意外胆囊癌诊疗方案的相关文献并进行综述。结果意外胆囊癌患者早期缺乏特异性症状和体征,选择适宜的影像学检查和肿瘤标志物检查能够提高其术前诊断率。根治性手术切除是意外胆囊癌最有效的治疗方式,但目前对于不同肿瘤分期的切除范围、采用腹腔镜或开腹手术方式的选择、二次手术时机等方面仍存在一定争议;术后辅助治疗可改善患者预后,但多数患者术后未接受相关辅助治疗。结论意外胆囊癌患者多为早期,多数可获得根治性切除,若首次手术未达到根治性切除或术后病理检查确诊,应综合评估肿瘤分期及患者一般情况后尽早完成补救性手术治疗。
Objective To understand the current progress of diagnosis and treatment of accidental gallbladder cancer.Method The relevant literatures about diagnosis and treatment of accidental gallbladder cancer and gallbladder cancer were analyzed and summarized.Results Due to the lack of specific symptoms and signs in most patients with accidental gallbladder cancer at the early stage,appropriate imaging examinations and tumor marker examinations could improve the preoperative diagnosis rate.The radical resection was the most effective method for accidental gallbladder cancer,but there were still some controversies about the scope of resection according to different tumor stages,the choice of laparoscopic cholecystectomy or open cholecystectomy,and the timing of reoperation.The postoperative adjuvant therapy could improve the prognosis of patients,but most patients didn’t receive adjuvant therapy after surgery.Conclusions Most patients with accidental gallbladder cancer are in the early stage,and most of them could obtain radical resection.If the first operation fails to achieve radical resection or postoperative pathological examination to confirm the diagnosis,comprehensive evaluation of the tumor stage and the patient’s general condition should be performed,and remedial treatment should be taken as soon as possible.
作者
宋绍明
田宏伟
李小飞
郭天康
SONG Shaoming;TIAN Hongwei;LI Xiaofei;GUO Tiankang(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,P.R.China;General Surgery Clinical Medical Center,Gansu Provincial Hospital,Lanzhou 730000,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2021年第3期409-414,共6页
Chinese Journal of Bases and Clinics In General Surgery
关键词
意外胆囊癌
术中冰冻切片
二次手术
综述
accidental gallbladder cancer
intraoperative frozen section
reoperation
review
