腹腔镜胆囊切除术遗漏恶性肿瘤的防治分析

目的探讨腹腔镜胆囊切除术漏诊恶性肿瘤的原因及其预防措施。方法回顾性分析2005年5月至2011年5月我院LC手术中6例漏诊恶性肿瘤的临床资料,并对之进行随访。结果 1859例LC共发生遗漏恶性肿瘤6例,包括右半结肠癌、胃癌各2例,胰腺癌、肝癌各1例,除2例右半结肠癌行根治性切除外,另外4例已不能行根治性手术。结论术前注意鉴别患者的症状,术中注意观察胆囊的病理改变及腹腔内有无异常情况,重视术后恢复时间长的老年患者可预防腹腔镜胆囊切除术遗漏恶性肿瘤。

Analysis of Missed Diagnosis of Malignant Tumor During Laparoscopic Cholecystectomy

Objective To investigate the causes and prophylactic measures of missing malignant tumor during laparoscopic cholecystectomy.Methods Clinical data of 6 patients who were missed diagnosis of malignant tumor during LC from May 2005 to May 2011 in our hospital were retrospectively analyzed and followed up.Results 6 malignant tumors were missed in 1859 cases of LC.The missed malignant tumors included right colon cancer(n=2),gastric cancer(n=2),pancreatic cancer(n=1) and hepatic cancer(n=1).Of all the malignant tumors,2 patients with right colon cancer underwent colectomy,the other 4 patients couldn’t be cured radically.Conclusion This study emphasizes the necessity to analyze carefully patients’ symptoms before operation,pay attention to pathological changes of gallbladder and intraabdominal situation intraoperatively,and follow up the aged patients who had a longer recovery time.