论文部分内容阅读
目的 总结胆囊癌的诊断和治疗经验。方法 对手术和病理确诊的胆囊癌 134例资料进行回顾性分析。随访 6个月至 16年。结果 B超检查正确率为 5 4 3% (88/16 2 ) ,电脑彩超正确率达 6 9% (2 9/4 2 ) ,CT结合增强扫描正确率达 85 % (46 /5 8)。NevinⅠ期 6例行单纯胆囊切除术 ,其中4例已生存 5年。NevinⅡ～Ⅳ期行胆囊癌根治性切除术 6 6例 ,平均生存 1年 8个月。NevinⅤ期行根治性或扩大根治性胆囊癌切除术 17例 ,平均生存期为 1年 3个月 ;10例NevinⅤ期行姑息性胆囊切除 ,平均生存 6个月 ;NevinⅤ期仅行剖腹探查术 35例 ,平均生存期仅 2个月。结论 电脑彩超可用做诊断早期胆囊癌的首选检查 ,晚期胆囊癌应与黄色肉芽肿性胆囊炎相鉴别。NevinⅤ期病人 ,只要没有腹水、凝血障碍和心肺肝肾的严重器质性病变 ,不应轻易放弃手术探查。
Objective To summarize the diagnosis and treatment experience of gallbladder cancer. Methods A retrospective analysis of 134 cases of gallbladder carcinoma confirmed by surgery and pathology was performed. Follow-up from 6 months to 16 years. Results The accuracy rate of B-mode ultrasonography was 544% (88/16 2). The accuracy rate of computer color ultrasonography was 69% (29/42). The accuracy rate of CT-enhanced scanning was 85% (46/5 8). Six cases of Nevin I were treated with simple cholecystectomy, and 4 of them had survived for 5 years. Nevin II ~ IV radical resection of gallbladder carcinoma in 66 cases, the average survival of 1 year and 8 months. NevinV had radical or enlarged radical gallbladder resection in 17 cases with an average survival of 1 year and 3 months; 10 cases of palliative cholecystectomy in NevinV, with an average survival of 6 months; NevinV only undergoing exploratory laparotomy. 35 For example, the average survival period is only 2 months. Conclusion Computer color scan can be used as the first choice to diagnose early gallbladder cancer. Late gallbladder cancer should be differentiated from xanthogranulomatous cholecystitis. NevinV patients should not easily give up surgical exploration as long as there are no ascites, coagulopathy, and severe organic disease of heart, lung, liver and kidney.