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目的分析意外发现的早期胆囊癌的临床治疗方法与预后。方法回顾性分析2005年5月至2010年5月漯河医学高等专科学校第二附属医院外一科收治的28例意外早期胆囊癌临床病理资料,对其治疗方法及影响预后的因素进行分析。结果 28例术中快速冰冻切片或术后病理切片证实为早期胆囊癌(NevinⅠ～Ⅱ期)。11例行单纯胆囊切除术,17例行根治术。多因素分析表明,组织学分级、Nevin分期及手术方式是影响预后的独立因素,单纯胆囊切除术组与胆囊癌根治术组患者的生存率差异有统计学意义。结论早期胆囊癌术前诊断困难,术中对可疑者做快速冰冻切片检查有助于发现早期胆囊癌,术中及术后一旦确诊即予施行根治术。
Objective To analyze the clinical treatment and prognosis of unexpected gallbladder carcinoma detected unexpectedly. Methods The clinical and pathological data of 28 cases of early gallbladder cancer admitted to the second affiliated hospital of the Second Affiliated Hospital of Luohe Medical College from May 2005 to May 2010 were retrospectively analyzed. The treatment methods and prognostic factors were analyzed. Results 28 cases of intraoperative rapid frozen section or postoperative pathology confirmed early gallbladder cancer (Nevin Ⅰ ~ Ⅱ period). 11 cases of simple cholecystectomy, 17 cases underwent radical surgery. Multivariate analysis showed that histological grade, Nevin staging and operation method were the independent prognostic factors. There was significant difference in survival rate between simple cholecystectomy group and radical cholecystectomy group. Conclusion The preoperative diagnosis of early gallbladder cancer is difficult. Fast frozen section examination of suspicious patients during surgery is helpful to detect early gallbladder cancer. Radical surgery should be performed once and within the diagnosis.