原发性胆囊癌30例诊治体会.docVIP

原发性胆囊癌30例诊治体会??【摘要】 目的 总结原发性胆囊癌的外科病例资料,提高原发性胆囊癌的诊断正确率和治疗效果。方法 回顾性分析1999年6月至2009年6月本院治疗的30例原发性胆囊癌的病例资料。结果 全组行B超或CT检查,诊断为胆囊癌的符合率分别为69. 3%、72. 5%;行剖腹探查并取活检术12例,单纯胆囊切除术9例, 2例行胆道内支架植入内引流术。病理学检查示腺癌20例。随访21例,1年内死亡11例, 2年内死亡6例, 3年内死亡3例, 1例存活5年以上。结论 手术是治疗原发性胆囊癌的首选方法,早期根治性手术对提高原发性胆囊癌患者的生存率具有重要意义。 【关键词】 原发性胆囊癌;诊治体会 Experience in diagnosis and treatment of primary gallbladder cancer in 30 cases WANG Xiang- bing,ZHOU Juan,ZHENG Xiaoqiu,et al. Second Peoples Hospital of Yibin City, Yibin Sichuan 644000, China 【Abstract】 Objective Summary of cases of primary gallbladder surgery information to improve the correct diagnosis of primary gallbladder carcinoma and therapeutic effect.Methods The data of diagnosis and treatment in 30 patients with primary gallbladder carcinoma during June, 1999 to June, 2009 in this hospital were retrospectively reviewed and analyzed.Results The accurate rates of B type ultrasonography and CT scanning were 69. 3 % and 72. 5 % respectively in patients of this group.Laparotomy and biopsy were taken in 12 cases, a simple chol- ecystectomy had been taken in 9 cases and routine biliary stent drainage was carried out in 2 cases. Pathological examination showed adenocarcinoma in 20 cases. 21 ca- ses were followed - up, death had happened in 11 cases during the year, death within 2 years in 6 cases, death in 3 years in 3 cases and survival in 1 case for more than 5 years.Conclusion Operation is the treatment for first choice for gallbladder cancer, early radical operation is important in raising the survival rate of patients with prima- ry gallbladder carcinoma. 【Key words】 Primary gallbladder carcinoma; Diagnosis and treatment experience 作者单位:644000宜宾市第二人民医院 原发性胆囊癌( PCG)是胆道系统常见的恶性肿瘤之一,外科手术是治疗本病的主要方法。现将1999年6月至2009年6月本院收治的30例原发性胆囊癌的病例资料报告如下。 1 资料与方法 1.1 临床资料 本组原发性胆囊癌患者30例,男16例,女14例,年龄29~69岁,平均(61. 7±3. 2)岁。临床症状表现为右上腹部疼痛者21例,右上腹部包块6例,黄疸4例,恶心2例,消瘦3例,发热1例,无症状者1例。合并胆囊结石、胆管结石14例,有胆囊息肉病史3例。本组行B超或CT检查,诊断为胆囊癌的符合率分别为69.3%、72.5%。 1.2 手术方式 本