原发性胆囊癌15例临床病理分析

本文分析15例原发性胆囊癌,男:女为1:6.5,平均年龄57.4岁,80％伴有胆结石,均高于国内一般统计资料。由于本病缺乏特殊的症状和体征,11例误诊为胆囊炎、胆石症。作者认为因胆囊炎、胆石症切除胆囊时应注意检查胆囊的大小、囊壁厚硬度,腔内有无乳头状增生及坏死、总胆管旁淋巴结是否增大,以免错过对癌症的根治机会。病理检查以浸润型腺癌多见。随访13例除一例局限在粘膜的早期癌外均在一年内死亡。都因手术太晚而无法根治,因此应主张及早手术治疗。

PRIMARY CARCINOMA OF THE GALLBLADDER: A CLINICAL AND PATHOLOGICAL ANALYSIS OF 15 CASES

15 cases of primary carcinoma of the gallbladder were analized in this paper. The male and female ratio was 1: 6.5 and the average age was 57.4. Eighty percent of the cases were accompenied with cholelithiasis, which was higher than the general statistics in our country. Eleven cases had been misdiagnosed as cholecystitis or cholelithiasis due to lack of specific symptoms and signs. The authors maintained that the surgeon must notice on gross examination about the size of the gallbladder; consistency of its wall; any papillary hyperplasia, necrosis or enlargement of the para-ductus choledochus lymph nodes in order not to lose the chance of radical operation for cancer while performing cholecystectomies due to cholecystitis or cholelithiasis. The main pathologic type in this series is invasive adenocarcinoma. Among 13 follow-up cases, all but 1 case whose early cancer was localized within mucosa died within 1 year, because the operation was too late and the chance of radical treatment was lost. Then the authors suggest that for this cancer surgical operation must be performed as early as possible.