摘要
目的观察腹腔镜胆囊切除术(LC)中意外发现胆囊癌(UGC)患者的预后及其影响因素。方法回顾性分析,收集2014年6月至2017年12月接受LC手术治疗术中发现UGC的125例患者资料,患者术后均接受为期3年的康复随访,全部患者随访资料、病历资料等均完整;根据患者随访资料,统计患者预后不良(胆囊癌复发、转移或病死)情况,根据结果分为预后不良组与预后良好组。设计基线资料填写表,详细填写2组患者的基线资料,纳入全部可能因素,经单因素及多因素分析找出LC术中UGC患者预后的影响因素。结果125例LC术中UGC患者术后随访3年,预后不良13例,预后不良发生率为10.40%(13/125);预后良好组与预后不良组LC术中UGC患者的结石类型、二次手术占比、术中发生胆漏占比及切除程度比较差异有统计学意义(P<0.05);经Logistic回归分析结果显示,胆囊结石、未行二次手术、术中发生胆漏、R1切除均是LC术中UGC患者预后不良的影响因素(OR>1,P<0.05)。结论胆囊结石、未行二次手术、术中发生胆漏、R1切除可能会增加LC术中UGC患者预后不良风险,该类患者应引起重视。
Objective To investigate the prognosis of patients with unexpected gallbladder cancer(UGC)during laparoscopic cholecystectomy(LC)and its influencing factors.Methods The data of 125 patients with UGC who were treated by LC in our hospital from June 2014 to December 2017 were retrospectively analyzed.All the patients received a 3-year rehabilitation follow-up after surgery.According to the follow-up data,the poor prognosis(recurrence,metastasis or death of gallbladder cancer)was statistically analyzed,and these patients were divided into poor prognosis group and good prognosis group.The basic data included possible factors that affected the prognosis of patients,which were analyzed by univariate analysis and multivariate analysis.Results After 3-year follow up,of the 125 patients,13 cases had a poor prognosis,with an incidence of poor prognosis being 10.40%(13/125).There were significant differences in the type of stones,the proportion of secondary operations,the proportion of intraoperative bile leakage during LC,and the degree of resection between the good prognosis group and the poor prognosis group(P<0.05).The Logistic regression analysis showed that gallbladder stones,no secondary surgery,intraoperative bile leakage,and R1 resection were the influencing factors of the poor prognosis of UGC patients during LC(OR>1,P<0.05).Conclusion Gallbladder stones,no secondary surgery,intraoperative bile leakage,and R1 resection may increase the risk of poor prognosis for patients with UGC during LC,therefor,it is necessary to pay mauch attention to these patients.
作者
梁长华
LIANG Changhua(Department of Hepatobiliary Surgery,Hechuan Disdrict People’s Hospital,Chongqing 401520,China)
出处
《河北医药》
CAS
2021年第20期3129-3132,共4页
Hebei Medical Journal
关键词
意外发现胆囊癌
腹腔镜
胆囊切除
预后
胆囊结石
胆漏
unexpected gallbladder carcinoma
laparoscopy
cholecystectomy
prognosis
cholecystolithiasis
bile leakage
