腹腔镜胆囊切除术与胆囊癌根治术治疗早期胆囊癌的疗效比较

目的通过对比研究，评价腹腔镜胆囊切除术（LC）与胆囊癌根治术（RC）两种方法治疗早期胆囊癌的临床疗效。方法采用回顾性研究，选择2001年1月-2008年12月期间，在我院确诊并行手术治疗的63例早期胆囊癌患者，按其所接受的治疗方法分为腹腔镜胆囊切除术组28例与胆囊癌根治术组35例。对两组患者术后的并发症发生率、生存率及复发率等方面进行比较。结果LC组患者术后并发症发生率为7．1％，与RC组的34．3％发生率相比，差异有统计学意义（P〈0．05）。RC组中Ⅰ期患者的术后第1、3、5年累积生存率均为100％，Ⅱ期为76．2％、42．9％和23．8％；LC组Ⅰ期为81．8％、54．5％和27．3％，Ⅱ期为17．6％、5．9％、0％。两组同期生存曲线经log-rank柃验，差异均有统计学意义（P〈0．01），RC组的生存率优于LC组。RC组术后1、3．5年肿瘤累积复发率分别为20．0％、48．6％、74．3％，LC组为60．7％、85．7％、92．9％，两组比较，差异有统计学意义（P〈0．01），RE组术后的复发率显著低于LC组。结论对于早期胆囊癌患者，首选的外科治疗方法是胆囊癌根治术，这对降低术后肿瘤复发率，提高远期生存质量有重要作用。

Comparison The Effect of Laparoscopic Cholecystectomy and Radical Cholecystectomy for The Patients with Early Gallbladder Carcinoma

Objective To compare the effectiveness of laparoscopic cholecystectomy （LC） and radical cholecystectomy （RC） for the patients with early gallbladder carcinoma. Methods From January 2001 to December 2008, 63 patients who had undergone LC or RC were analyzed retrospectively. The survival and recurrence rate after operation and complication were compared. Results After treatment, the complication in LC group was less than that in RC group （P 〈 0.05）. In the RC group, the 1-, 3-, 5- year overall cumulative survival rate of Nevein phase I were all 100%, and 76.2%, 42.9%, 23.8% respectively in the phase Ⅱ of the RC group. Accordingly, the overall cumulative survival rate of LC cases were 81.8%, 54.5%, 27.3% in phase Ⅰ and 17.6%,5.9% ,0% in phase Ⅱ. The difference between the survival curves was statistically significant （P 〈 0.01）. The 1-, 3-, 5- year cumulative recurren~ rates after RC and LC treatment were 20.0%, 48.6%, 74.3% versus 60.7%, 85.7%, 92.9% respectively. The difference between the two recurrence curves have statistical significance （P 〈 0.01）. Conclusion RC is one of the first choices for early gallbladder carcinoma treatment, and shows positive results to reducing recurrence rate and promoting long-term life quality.