原发性胆囊癌48例诊治分析

[目的]探讨分析胆囊癌诊断和治疗。[方法]回顾性分析1990年1月-2004年12月蒲城县人民医院和大连医科大学第一临床学院48例经术中和病理确诊胆囊癌病例。[结果]术前确诊28例。术前未予确诊的20例,经手术或冷冻切片均确诊,术后病理切片证实48例。随访46例。住院期内共死亡0例,出院3个月内死亡2例。累计存活1年以上者34例,3年者22例,5年者14例。[结论]胆囊癌的诊断易受结石、黄疸、炎症等影响。术中疏忽和未作冰冻切片可影响术中诊断和恰当的治疗。术后生存期与分期密切相关,亦与手术方法有关,根治性手术、二次手术及复发再手术可提高胆囊癌病人的生存率。

Diagnosis and treatment of 48 cases with gallbladder cancer

[Objective] To discuss diagnosis and treatment of gallbladder carcinoma.[Methods] The clinica1 data of 48 cases of gallbladder carcinoma from January,1990 to December,2004 were retrospectively analyzed.[Results] Of al1 the 48 patients 28 cases obtained confirmative diagnosipreoperatively.In 20 cases without preoperative confirmative diagnosis,20 cases obtained confirmative diagnosis surgical operation and frozen sections,and 48 cases by pathologica1 section observation postoperatively.46 cases were followed up.No cases died during hospitalization and 2 cases died 3 months after leaving hospita1.After operation,1,3,5-year survival cases were 34,22 and 14 respectively.[Conclusion] Diagnosis of gallbladder carcinoma is affected by 1ithiasis,inflammation.jaundice and so on.Carelessness and no frozen section iso-methods during operation can influence the rediagnosis and appropriate therapeutics.The postoperative survival rate was significantly affected by the clinical stage of gallbladder carcinoma and the way of operation,second operation and re-operation after recurrence can raise surviva1 rate of the patients with gallbladder carcinoma.