肝外胆道癌1 430例临床及ICD-10编码分析

目的探讨某院肝外胆道癌的发病、诊断及治疗情况。 方法用ICD-10编码总结并分析了1950年至2010年广州市某三甲医院收治的肝外胆道癌1 430例临床资料,其中胆囊癌417例,胆道癌1 013例。 结果肝外胆道癌占同期肝外胆道疾病患者的3.73%,10年发病率增加87.03%;胆囊癌占肝外胆道癌的29.2%,中位年龄为47.3岁,男女比例为1∶1.12;手术率为63.5%,肿瘤切除率为55.5%;胆管癌占肝外胆道肿瘤的70.8%,中位年龄为47.3岁,男女比例为1.56∶1,手术率为76.0%,肿瘤切除率为45.1%。肝外胆道癌病案首页信息编码错码率为37.8%(391/1 035)。 结论胆囊癌及胆管癌的发病率均有上升趋势;肿瘤切除率有所提高,ICD-10错码率有待优化。

Retrospective analysis of 1 430 extrahepatic biliary carcinoma patients in ICD-10 code

ObjectiveTo explore the morbidity change of extrahepatic biliary carcinoma and choices of surgical approach, and to analyze the file error rate of ICD-10 code. MethodsClinical data of 1 430 patients with extrahepatic biliary carcinoma treated in a tertiary hospital in Guangzhou from 1950 to 2010 with ICD-10 code were analyzed. Among them, 417 patients had gallbladder carcinomas, and 1 430 cholangiocarcinomas. ResultsThe extrahepatic bile duct carcinoma consisted 3.73% of bile duct diseases of the same period, while the incidence rate raised 87.03% during 10 years. Gallbladder carcinomas and cholangiocarcinomas accounted for 29.2% and 70.8% of extrahepatic bile duct carcinomas, while both mean ages were 47.3 years old, respectively. The sex ratio (male ∶ female) was 1∶1.12 and 1.56∶1. The operation rate and resection rate were 63.5% and 55.5% in gallbladder carcinoma while 76.0% and 45.1% in cholangiocarcinoma. The ICD-10 code error rate of extrahepatic biliary carcinoma reached 37.8% (391/1 035). ConclusionBoth the incidence rate and resection rate of extrahepatic biliary carcinoma are elevated gradually. The error rate of ICD-10 code needs to be optimized.