意外胆囊癌的临床诊断和治疗分析

目的探讨意外胆囊癌的诊断和治疗。方法对我院1998年5月-2007年4月35例意外胆囊癌的患者资料进行回顾性分析。结采术前诊断幔性结石性胆囊炎症21例，急性结石性胆囊炎症5例，单纯胆囊姑石3例，胆囊息肉6例。开腹胆囊切除术13例，腹腔镜胆囊切除术22例。术中冷冻切片证实胆囊癌25例，术后病理确诊10例。行单纯胆囊切除11例，胆囊癌根治术14例，10例二期行胆囊癌根治术。结论意外胆囊癌术前诊断困难，重视高危因素、术中快速冷冻切片检查是意外胆囊癌诊断的重要依据。而尽快实施手术治疗，并力求根治性切除是其治疗原则。手术为胆囊癌最有效的治疗手段，早期发现、合理治疗为提高胆囊癌生存的有效措施。

Diagnosis and treatment of nsuspected gallbladder carcinoma(UGC)

Objective To investigate the diagnosis and treatment of unsuspected gallbladder carcioma.Methods The clinical data of 35 patients with unsuspected gallbladder carcinoma treated in our hospital from May 1998 to April 2007 were retrospecfively analyzed.Results Thirty five cases were found unsuspectedly by operation,of which 13 were found in open cholecystectomy and 22 in laparoscopic cholecystectomy although 21 cases were diagnosed as chronic calculus cholecystitis,5 cases diagnosed as acute calculus cholecystitis,3 cases diagnosed as pure chocystolithiasis and 6 cases diagnosed as gallpolyp before operation.All 35 cases were confirmed as gallbladder carcinoma by frozen section examination during operation or pathological examination after operation. Eight cases received pure Cholecystectomy, Seven cases received radical resection immediately and 10 underwent second resection. Conclusion It is diffiult to diagnose unsuspected gallbladder earcinoma before operation. High risk factors valued and frozen section examination should be performed for suspected lesions,whieh contribute a lot to the diagnosis of unsuspected gallblader carcinoma. Radical resection should be performed immediately once the diagnosis is confirmed. Surgery is the primary therapeutic method for unsuspected gallbladder carcinoma early finding and reasonable therapy are important for enhancing the survival of patients with unsuspected gallbladder carcinoma.