腹腔镜胆囊切除术对意外性胆囊癌预后的影响

目的：探讨腹腔镜胆囊切除术（LC）对意外性胆囊癌的影响。方法：回顾性分析经术后病理证实为胆囊癌者21例临床资料，其中11例行腹腔镜胆囊切除术（LC），10例行开放性胆囊切除术（OC），对比两组累积存活比率和5个预后因素，包括组织分级、病理分期、胆汁溢出发生率、手术类型以及附加的外科治疗。结果：8例（72.7%）LC术后及7例OC术后（70.0%）出现肿瘤复发，两者差异无统计学意义（P=0.86），两组均无腹壁转移。生存率与肿瘤分期和胆汁溢出有关（P=0.006和P=0.003），生存率与上述两种手术方式无关(P=0.74)。结论：LC不影响意外性胆囊癌的预后。

The impact of laparoscopic cholecystectomy on the prognosis of unsuspected gallbladder cancer

ObjectiveTo evaluate the impact of laparoscopic cholecystectomy (LC) on the prognosis of unsuspected gallbladder cancer(GC).Methods A retrospective clinicopathologic study was performed on 21 patients with unsuapective GC,but diagnosed gallbladder cancer postoperatively by pathology. Of which, 11patients underwent LC and 10 patients underwent open cholecystectomy (OC), The correlation was evaluated between cumulative survival rates and the following 5 prognostic factors: histopathological grade, pathologic stage, occurrence of bile spillage, type of cholecystectomy (LC or OC), and additional surgical treatments.ResultsEight patients (73%) after LC and 7 patients (70%) after OC had cancer recurrence,and the difference was of no statistical significance (P=0.86). There were no recurrences of cancer in the abdominal wall after either LC or OC. Survival rate was statistically correlated to tumor stage (P=0.006),and to the occurrence of bile spillage (P=0.003). Survival rate did not differ according to whether the operation was carried out using LC or OC (P=0.74). Conclusions LC does not worsen the prognosis of unsuspected gallbladder cancer.