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目的 探讨提高原发性胆囊癌早期诊断和治疗的有效途径。方法 对我院 1992～ 2 0 0 2年经手术和病理证实的胆囊癌临床资料进行回顾性分析。结果 术前诊断率 73 9% ,B超和CT是诊断胆囊癌的主要检查手段。手术切除率 5 2 2 % ,1年生存率 39% ,5年生存率 6 %。结论 Ⅰ期、Ⅱ期胆囊癌可仅作单纯胆囊切除术 ;Ⅲ期和Ⅳ期需行扩大胆囊切除术 ;Ⅴ期如伴阻黄则尽可能行姑息性胆道内或外引流手术。早期诊断和合理的术式是延长病人生存时间的主要手段。对胆囊癌高危人群应积极行预防性胆囊切除术。
Objective To explore an effective way to improve the early diagnosis and treatment of primary gallbladder cancer. Methods The clinical data of gallbladder carcinoma confirmed by operation and pathology in our hospital from 1992 to 2002 were retrospectively analyzed. Results The preoperative diagnosis rate was 73.9%. B-ultrasound and CT were the main methods of diagnosis of gallbladder cancer. Surgical resection rate 52.2%, 1-year survival rate 39%, 5-year survival rate 6%. Conclusions Stage I and II gallbladder carcinomas may be treated by simple cholecystectomy. Stage III and IV may be performed with cholecystectomy. Stage V may be treated with palliative biliary extrinsic or external drainage if possible. Early diagnosis and rational operation is to prolong the survival of patients the main means. Preventive cholecystectomy should be actively carried out in high-risk patients with gallbladder cancer.