胆囊癌52例临床分析

目的研究提高胆囊癌疗效的途径。方法对１９８４～１９９５年间收治的５２例胆囊癌患者进行回顾性临床分析。结果５２例中，男８例，女４４例，男女之比为１∶５．５。５０岁以上者４４例，占８４．６％。合并慢性胆囊炎、胆囊结石４４例，占８４．６％。术前影像学确诊者２０例，术中及术后病理确诊者３２例，其中７例术中漏诊，占２１．９％。５２例行探查手术，３６例切除病变胆囊，切除率６９．２％，其中行根治性切除７例，根治率１３．５％。本组总的５年存活率３．８％，约６０％的患者于术后１年后死亡。结论目前临床发现的胆囊癌极大部分属于中、晚期，疗效令人失望。提高疗效的途径在于早期发现和处理胆囊癌高危病变，预防胆囊癌形成。强调避免术中漏诊对预后的重要性。

Clinical analysis of gallbladder carcinoma in 52 cases

Objective To improve the therapeutic efficacy of gallbladder carcinoma. Method A retro-spective clinical analysis was made in 52 cases of gallbladder carcinoma, who were admitted to and treated in ourhospital between 1984-1985. Results The 52 patients were 8 males and 44 females with a male to female ratioof l:5.5. Among them 44 cases (84. 6% ) aged older than 50 years and 44 (84. 6 %) patients were associatedwith chronic cholecystitis and gallstones. There were 20 cases diagnosed correctly before operation, while the other32 cases were diagnosed during or post operation, among them 7(21. 9%) cases were misdiagnosed in operationand most of them were of I or II stage. All the 52 cases were subjected to an exploratory operation and in 36 ofthem the lesions were resected with a resectable rate of 69. 2%, and in 7(13. 5%) of them were radically resect-ed. The 5-year survival rate in this series was 3.8%. About 60% of the patients died longer than 1 year after op- eration. Conclusions Currently, most patients with gallbladder carcinoma are of middle to late Stages on admis-sion. The therapeutic efficacy is still not satisfactory. Patholodcal finding and resection of the high-risk lesions forgallbladder carcinoma on the can prevent formtion of gallbladder carcinare. To avoid misdiagnosis during opera-tion is very important in prognosis.