原发性胆囊癌误漏诊临床分析

原发性胆囊癌误漏诊临床分析
王宇;段文涛
【期刊名称】《临床误诊误治》
【年(卷),期】2017(30)8
【摘要】Objective To summarize clinical features of primary gallbladder carcinoma in order to analyze causes of missed diagnosis or misdiagnosis of gallbladder stones before operation to provide prevention
method.Methods Clinical data of 20 patients with primary gallbladder carcinoma confirmed by operation and postoperatively pathological results, who admitted during January 2011 and January 2014, was retrospectively analyzed.Results Among the 20 patients, 15 patients visited doctors for continuing pain in right upper quadrant of the abdomen;2 patients visited doctors for jaundice;3 patients visited doctors for nausea, vomiting, loss of appetite, obvious weight loss and fatigue.Abdominal mass was found in 1 patient.A total of 8 patients were confirmed diagnosis before surgery, 2 patients were suspected as having gallbladder carcinoma combined with cholecystolithiasis;5 patients were misdiagnosed as having cholecystolithiasis;5 patients were missed diagnosis.Among the 20 patients, 4 patients underwent gallbladder removal only;11 patients underwent gallbladder removal, hepatic tissue excision and partly lymphaden cleaning;5 patients underwent T tube drain outside the gallbladder;all patients were confirmed the diagnosis by rapid frozen pathology during
the operation and (or) routine pathological examination after operation.There were 1 patient with biliary fistula, 1 patient with abscess and 3 patients with incisional infection after operation, and all patients were cured after symptomatic treatments.The survival rate of 20 patients before discharging was 100.0%.The median follow-up time was 2.3 years.At the end of the follow-up, 14 patients were survival, and 6 patients were died.Conclusion Gallbladder cancer and cholecystolithiasis have many similarities in clinical manifestations, and it is easily misdiagnosed.Patients with high risk factors of gallbladder cancer should take imaging and laboratory tests termly, and invasive examination if necessary in order to avoid missed diagnosis or misdiagnosis for primary gallbladder carcinoma.%目的探讨原发性胆囊癌临床特点,分析其术前误诊为胆囊结石和漏诊的原因并提出防范措施.方法回顾性分析2011年1月-2014年1月南充市中心医院肝胆外科收治的经手术和病理检查证实原发性胆囊癌20例的临床资料.结果 20例中以右上腹部持续疼痛就诊15例,以黄疸就诊2例,以恶心、呕吐、食欲不振、体重明显减轻
和乏力就诊3例;发现腹部肿块1例.术前确诊8例,疑为胆囊癌合并胆囊结石2例,
误诊为胆囊结石5例,漏诊5例.20例行单纯胆囊切除4例,胆囊切除与部分肝组织切除、部分淋巴结清除11例,胆囊外T管引流手术5例,均经术中快速冷冻病理检
查和(或)术后常规病理检查证实胆囊癌.20例中术后出现胆瘘1例,脓肿1例,手术切口感染3例,均给予相应治疗痊愈.20例出院前存活率100.0%;随访1~5年,中位随访时间2.3年,至随访结束时存活14例,死亡6例.结论胆囊癌和胆囊结石临床表现有许多相似之处,易误诊.临床上对具有胆囊癌高危因素的患者需定期行影像学和实验室检查,必要时行有创性检查,以减少或避免原发性胆囊癌误诊.
【总页数】4页(P8-11)
【作者】王宇;段文涛
【作者单位】637000 四川南充,南充市中心医院肝胆外科;637000 四川南充,南充市中心医院肝胆外科
【正文语种】中文
【中图分类】R735.8
【相关文献】
1.D-二聚体阴性肺栓塞四例误漏诊临床分析 [J], 雷松;李丽
2.原发性胆囊癌的超声诊断及误漏诊分析 [J], 吴琪;胡元平
3.胆囊结石合并原发性胆囊癌误漏诊18例分析 [J], 刘继祥
4.少见病理类型宫颈癌误漏诊临床分析 [J], 刘晓华;吴庆蓉;续云芳
5.左心衰竭误漏诊为慢性支气管炎急性发作16例临床分析 [J], 许久军; 张娟; 张连珍; 许敏; 崔素军; 王翠平; 李翠红
因版权原因，仅展示原文概要，查看原文内容请购买。