原发性胆囊癌外科诊治分析.docVIP

原发性胆囊癌外科诊治分析 　　【摘要】 目的 总结原发性胆囊癌的外科诊治体会。方法 回顾性分析本院治疗的56例原发性胆囊癌的诊治资料。结果 本组患者行单纯胆囊切除、标准根治术等外科治疗。病理学检查结果示腺癌37例(66.1%),黏液腺癌8例(14.3%),鳞状细胞癌7例(12.5%),类癌4例(7.2%)。按Nevin分期,I期5例(8.9%),Ⅱ期7例(12.5%),Ⅲ期12例(21.4%),Ⅳ期20例(35.7%),V期12例(12.5%)。随访49例(87.5%),存活1年以上18例,1年内死于肿瘤31例,1年生存率为36.7%。术后并发症发生率为5.4%。结论 外科手术是治疗原发性胆囊癌的首选方法,早期诊断和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;外科;诊治分析 　　 　　Experience of surgical treatment on primary carcinoma of the gallbladder (report of 56 cases) 　　WEN Zi-yi.Department of General Surgery,Heyuan People’s Hospital,Heyuan 517000,China 　　 　　【Abstract】 Objective To explore the experience of surgical treatment on primary carcinoma of the gallbladder.Methods To analyze the clinical data of 56 cases of primary carcinoma of the gallbladder patients retrospectively.Results This group patients were treated with simple cholecystectomy,the standard surgical treatment and others methods.Pathological examination: 37 cases of adenocarcinoma(66.1%),8 cases of mucinous adenocarcinoma(14.3%),7 cases of squamous cell carcinoma(12.5%),4 cases of carcinoid(7.2%).Nevin stage: 5 cases of I period(8.9%),7 cases of Ⅱ period(12.5%),12 cases of Ⅲ period(21.4%),20 cases of Ⅳ period(35.7%),12 cases of V period(12.5%).In the follow-up of 49 cases (87.5%),a year survival rate was 36.7%.The postoperative complication rate was 5.4%.Conclusion Surgery is the preferred method of treatment on p primary carcinoma of the gallbladder.Early diagnosis and early radical surgery have a great significance in improving survival of the PCG patients. 　　【Key words】 Primary carcinoma of the gallbladder;Surgical;Diagnosis and treatment 　　 　　作者单位:517000河源市人民医院普外科 　　 　　原发性胆囊癌(PCG)是胆道系统最常见的恶性肿瘤,占消化系统恶性肿瘤发生率的前位。因其症状和体征不具有特异性,所以早期诊断率较低。虽然随着CT、MR在临床上的应用不断广泛,胆囊癌的早期诊断率较前有所提高,但由于它具有恶性程度高、病情发展快、根治机会少的特点,预后仍然很差,越来越被外科临床所重视。本文对本院2006年3月至2008年7月诊治的56例PCG患者的临床资料进行回顾性分析,报道如下。 　　1 资料与方法 　　1.1 临床资料 本组56例,男21例,女35例,年龄29～68岁,平均(57.4±3.8)岁。主要临床表现:右上腹部疼痛者27例(48.2%),右上腹部包块15例(26.8%),黄疸8例(14.3%),发热4例(7.1%),恶心1例