意外胆囊癌的外科诊疗体会

意外胆囊癌的外科诊疗体会

[摘要] 目的探讨意外胆囊癌疾病的临床正确外科诊治方法，提高患者治疗效果，保障患者生活质量与生命安全。方法对2009

年1～12月期间我院治疗的26例意外胆囊癌患者给予临床资料回顾性分析。结果 26例意外胆囊癌患者采用外科治疗方法主要为单纯胆囊切除术、胆囊切除术联合淋巴结清扫、胆囊切除术与肝楔形切除术联合淋巴结清扫、胆囊切除术与肝门胆管空肠吻合联合淋巴结清扫；26例意外胆囊癌患者经上述方法治疗后，近期治疗总有效率为73.08%，具有满意的临床疗效；患者均经治疗后出院，对其进行术后3年有效随访，随访率为100%，术后3年内死亡患者为2例，其原因为患者发生淋巴结转移。结论临床应根据意外胆囊癌患者实际病情，选择合适的手术治疗方法，从而达到更为有效的治疗目的，切记盲目进行癌变根治手术，以减轻患者手术痛苦，提高患者生活质量与生命安全。

[关键词] 意外胆囊癌；外科；临床诊治

[中图分类号] r735.8 [文献标识码] b [文章编号] 2095-0616（2013）15-175-02

the diagnosis and surgical treatment of unexpected gallbladder carcinoma

bai xiaobin

department of minimally invasive surgery，the first people’s hospital of pingdingshan city in henan province，

pingdingshan 467000，china

[abstract] objective to discuss the correct clinical diagnosis method and surgical treatment of unexpected gallbladder cancer disease，improve the effect and ensure quality of life and life safety. methods a clinical data of 26 cases of patients with gallbladder carcinoma was retrospectively analyzed from jan.1，2009 to dec.31，in our hospital. results 26 cases of patients with unexpected gallbladder cancer were treated with surgical treatment method for simple cholecystectomy，cholecystectomy combined with lymph node dissection， cholecystectomy and liver wedge resection combined with lymph node dissection，cholecystectomy and porta hepatis bile duct jejunum anastomosis combined with lymph node dissection；26 cases of patients with unexpected gallbladder carcinoma were treated with the above methods after treatment，the total effective rate of recent treatment was 73.08% with a satisfactory clinical efficacy；the patients were discharged and followed up for 3 years after treatment，the follow-up rate was 100%；there were 2 patients with postoperative death in three years，because of the incidence of lymph node metastasis. conclusion we should choose appropriate operative treatment according

to the actual condition of patients with unexpected gallbladder carcinoma， in order to achieve more effective therapeutic purposes， not blind to do cancer radical operation， reduce the operation pain and improve patient’s safety and quality of life.

[key words] unexpected gallbladder carcinoma；surgery；diagnosis and treatment

本研究对2009年1月～12月前来就诊的26例意外胆囊癌患者进行临床分析，探讨意外胆囊癌疾病的临床正确外科诊治方法，以提高患者治疗效果，保障患者生活质量与生命安全，现报道如下。

1 资料与方法

1.1 一般资料

将2009年1～12月前来就诊的26例意外胆囊癌患者进行临床分析，其中男9例，女17例，患者年龄最大79岁，最小38岁，平均（52.4±1.5）岁，病程3个月～7年，平均（3.3±0.6）年，其中22例患者同时伴有结石。意外胆囊癌患者临床表现为上腹疼痛、食欲下降、发热、呕吐、恶心等。经病理证实可知：未分化癌患者为1例、腺鳞癌患者为1例、高分化癌患者为13例、中分化癌患者为7例、低分化腺癌患者为4例。经nevin分期可知：ⅰ期患者为2例、ⅱ期患者为4例、ⅲ期患者为11例、iv期患者为5例、v 期患者为4例。

1.2 纳入与排除标准[1]