Nevin V期胆囊癌的诊断和治疗

目的总结NevinV期胆囊癌的诊断和治疗经验。方法对手术和病理确诊的NevinV期胆囊癌74例资料进行回顾性分析。结果电脑彩超正确率达75.0％(21/28)，CT结合增强扫描正确率达82.1％(32/39)。NevinV期行根治性或扩大根治性胆囊癌切除术23例，平均生存期为1年3个月；11例NevinV期行姑息性胆囊切除，平均生存5个月；NevinV期仅能行剖腹探查和活检术、对症治疗38例、腹腔镜探查和活检2例，平均生存期仅2个月。结论对无手术禁忌证的病人应积极行手术探查、腹腔镜探查和活检。病变范围较广泛者可行肿瘤化疗药敏试验、区域动脉灌注化疗、记忆合金胆道内支架应用等综合措施，可延长病人的生存期。

Diagnosis and treatment ofNevin Stage V gallbladder cancer

Objective To summarize the experience of diagnosis and different surgical management for Nevin Stage V gallbladder cancer. Methods The present study was an retrospective analysis of 74 patients who were operated in our hospital and suffered from Nevin Stage V gallbladder cancer proved histopathologically. Results The diagnostic accuracy of color Doppla ultrasound was 75.0%(21/28), abdominal enhanced CT, 82.1%(32/39).23 patients with Nevin Stage V disease received radical or extended radical cholecystectomy, the mean survival time was 1 year and 3 months;11 patients with Nevin Stage V disease without a complete resection had a mean survival of 6 months; 38 patients with Nevin Stage V diesase had a mean survival of 2 months after palliative bypass procedure or biopsy. Conclusion A exploratory operation by laparoscope is useful in the diagnosis of advanced gallbladder cancer. According to local situation of gallbladder cancer and general body state, different management are employed in treatment so that the effect may be improved.