腹腔镜下胆囊旁肝癌的微波消融治疗

目的探讨腹腔镜辅助下微波消融治疗胆囊旁肝癌的方法及疗效。方法16例有胆囊旁肝癌的病例接受了腹腔镜胆囊切除术联合腹腔镜下微波凝固术治疗,总共27个癌灶中的18个被彩超和/或CT证实为贴近胆囊。观察术后并发症的发生,并作术后随访观察疗效。结果本组病例均无严重并发症和死亡病例。术前AFP升高的12例患者在术后1个月时9例显著降低,3例无改变;术后1个月复查超声造影和增强CT,25个病灶完全坏死,2例残留癌灶,1例新发癌灶,再次行经皮微波凝固术后完全坏死。结论腹腔镜胆囊切除术联合腹腔镜下微波凝固术使胆囊旁肝癌患者获得了微创治疗的机会,扩大了微波消融术治疗肝癌的范围。

Laparoscopic microwave ablation therapy for the treatment of liver cancer closed to gallbladder

Objective To explore the technique and therapeutic efficacy of laparo-assisted microwave ablation for liver cancer closed to gallbladder.Methods 27 hepatic tumors were treated with Laparoscopic cholecystectomy(LC)and laparoscopic-assisted microwave ablation therapy(LMC)in 16 patients.18 lesions were identified to be closed to the gallbladder by ultrasound and/or CT scan.Postoperative complications and follow up curative effect were observed.Results No patients had serious complications or died.9 out of 12 patients's level of AFP were declined obviously.Complete ablation were achieved in 25 lesions,incomplete of ablation had 2 lesions,and one new tumor was discovered by CT scans or/and contrast enhanced ultrasound(CEUS)in 1 month after operation.Conclusion Microwave ablation could be used to cure liver cancer closed to gallbladder,and it would extend the therapeutic extent of liver cancer.