原发性进展期胆囊癌肝转移的临床病理与手术方式的选择

目的：本文依据进展期胆囊癌肝转移的临床病理学特点，探讨其手术方式。方法：对163例手术切除的原发性进展期胆囊癌进行临床病理学研究，并对原发癌的临床病理学诸因子与肝转移的关系进行了分析。结果：胆囊癌侵及肝脏达20mm以上，癌已侵达胆囊浆膜外或已侵及周围脏器，主癌灶位于胆囊肝床侧或己侵及胆囊全周，高度的静脉，淋巴管浸润是胆囊癌肝转移的5个高危因素，胆囊癌有转移至第4、5肝段的倾向（61．5％），这种倾向在早期的肝转移时更为明显（92％），结论：应根据肝转移的高危因素及转移灶的分布特点，合理地选择肝床切除，肝段切除，肝切除＋肝动脉插管化疗等手术方式。

Clinicopathological features and stwgical management of liver metastasis of progressive gallbladder carcinoma

Objective To analyze the clinicopathological features of liver metastasis of progressive gallbladder carcinoma and discuss its surgical management. Methods A retrospective clinicopathological study was conducted on 163 patients receiving surgical resection of primary progressive gallbladder carcinoma. Meanwhile, the relationship between clinicopathological factors and hepatic metastasis was determined. Results The 5 high risk factors for hepatic metastasis were: 1) hinf3;2) se and si carcinoma;3) the location of the lesion on hep/circ;4) ly3;5) v3. More than half of the metastases were located in segment 4 and 5 (61 5%). Conclusions Appropriate surgical management can be chosen according to the high risk factors of hepatic metastases and the distributive characteristics of the metastatic lesions.